Provider Demographics
NPI:1093167173
Name:LYNCH, DAINETTE
Entity Type:Individual
Prefix:
First Name:DAINETTE
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAINETTE
Other - Middle Name:
Other - Last Name:LUKOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMINISTRATION
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:79 BEACON ST
Practice Address - Street 2:WOMEN AND CHILDRENS PROGRAM
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06704-3424
Practice Address - Country:US
Practice Address - Phone:203-574-3311
Practice Address - Fax:203-574-3315
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker