1578555124 NPI number — MR. THOMAS LYNCH CRNA

Table of content: MR. THOMAS LYNCH CRNA (NPI 1578555124)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578555124 NPI number — MR. THOMAS LYNCH CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYNCH
Provider First Name:
THOMAS
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
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:
1578555124
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/06/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43 KENSICO DR
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
MOUNT KISCO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10549-1009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-666-8866
Provider Business Mailing Address Fax Number:
914-666-6777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
LEWISTOWN HOSPITAL
Provider Business Practice Location Address City Name:
LEWISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17044-1167
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-248-5411
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/19/2005

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: 367500000X , with the licence number:  RN193706 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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