Provider Demographics
NPI:1104828219
Name:LYNDE, WILLIAM S (DPM)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:LYNDE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 NEWTOWN YARDLEY RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1748
Mailing Address - Country:US
Mailing Address - Phone:215-968-8700
Mailing Address - Fax:215-968-8523
Practice Address - Street 1:770 NEWTOWN YARDLEY RD
Practice Address - Street 2:SUITE 215
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1748
Practice Address - Country:US
Practice Address - Phone:215-968-8700
Practice Address - Fax:215-968-8523
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2024-02-26
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-17
Provider Licenses
StateLicense IDTaxonomies
PASC001816L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU02089Medicare UPIN