Provider Demographics
NPI:1093466674
Name:LOIS L LYNN NUTRITIONIST PLLC
Entity Type:Organization
Organization Name:LOIS L LYNN NUTRITIONIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:RDN,CDN,CLMP
Authorized Official - Phone:212-222-6444
Mailing Address - Street 1:222 RIVERSIDE DR APT 8E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6809
Mailing Address - Country:US
Mailing Address - Phone:212-222-6444
Mailing Address - Fax:
Practice Address - Street 1:222 RIVERSIDE DR APT 8E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6809
Practice Address - Country:US
Practice Address - Phone:212-222-6444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty