Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F400784-1 | NY |
NPI | 1033242920 |
---|---|
Provider Name | Kathleen Mary Lynch |
First Address | Garden City, NY 11530-2520 |
Second Address | Garden City, NY 11530-2520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 08/07/2007 |