Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | DC-004987-L | PA |
Y | 111NN0400X | Neurology | X006994-1 | NY |
NPI | 1770681215 |
---|---|
Provider Name | Dr. Lynn B Pownall |
First Address | Jamestown, NY 14701-6653 |
Second Address | Jamestown, NY 14701-6653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00020097901 | UNIVERA PROVIDER NUMBER (01) | NY |
000211411001 | BLUE CROSS BLUE SHIELD (01) | NY |
161420676-02 | PRISM HEALTH NETWORKS (01) | NY |
5802491 | GHI PROVIDER NUMBER (01) | NY |
8809742 | INDEPENDENT HEALTH (01) | NY |
U31676 | (02) | NY |