1013243385 NPI number — MR. JAMES HUBERT LYNCH NP-C

Table of content: MR. JAMES HUBERT LYNCH NP-C (NPI 1013243385)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013243385 NPI number — MR. JAMES HUBERT LYNCH NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYNCH
Provider First Name:
JAMES
Provider Middle Name:
HUBERT
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
NP-C
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013243385
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/27/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
130 W MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHORTSVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14548-9722
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-231-3179
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28 CAYUGA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SENECA FALLS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13148-1417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-568-4415
Provider Business Practice Location Address Fax Number:
315-568-4332
Provider Enumeration Date:
10/21/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP2300X , with the licence number:  33 339233 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)