1265402887 NPI number — DR. GREGORY M LYNCH MD

Table of content: DR. GREGORY M LYNCH MD (NPI 1265402887)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265402887 NPI number — DR. GREGORY M LYNCH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYNCH
Provider First Name:
GREGORY
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1265402887
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 BUTTRICK RD STE 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONDONDERRY
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03053-3417
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-537-1300
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 TSIENNETO RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
DERRY
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-537-1300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/25/2006

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: 207Q00000X , with the licence number:  8168 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0706624 . This is a "AETNA USHC" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30003041 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: E13699 . This is a "HARVARD" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 0102704 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 404436 . This is a "TUFTS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com