Provider Demographics
NPI:1164648150
Name:LYNCH WOOD OPTICIANS
Entity Type:Organization
Organization Name:LYNCH WOOD OPTICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:PARTNER
Authorized Official - Phone:856-428-8084
Mailing Address - Street 1:118 BARCLAY CENTER
Mailing Address - Street 2:ROUTE 70
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034
Mailing Address - Country:US
Mailing Address - Phone:856-428-8084
Mailing Address - Fax:856-428-3233
Practice Address - Street 1:118 BARCLAY CENTER
Practice Address - Street 2:ROUTE 70
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034
Practice Address - Country:US
Practice Address - Phone:856-428-8084
Practice Address - Fax:856-428-3233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0238700001Medicare NSC