Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N004991 | NY |
NPI | 1134179740 |
---|---|
Provider Name | Kathleen M Lynch |
First Address | Fayetteville, NY 13066 |
Second Address | Fayetteville, NY 13066-1331 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 27/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01680491 | (05) | NY |
U33501 | (02) |