Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 272974 | NY |
Y | 208800000X | Urologist | 5101018093 | MI |
NPI | 1063640431 |
---|---|
Provider Name | Dr. Lynn Paik |
First Address | Media, PA 19063-3434 |
Second Address | Media, PA 19063-3434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 01/06/2017 |