Provider Demographics
NPI:1164782116
Name:TOMCZAK, LYNNLEE E (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:LYNNLEE
Middle Name:E
Last Name:TOMCZAK
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:27 NORTH MAIN STREET
Mailing Address - City:ELBA
Mailing Address - State:NY
Mailing Address - Zip Code:14058-0186
Mailing Address - Country:US
Mailing Address - Phone:585-757-2317
Mailing Address - Fax:
Practice Address - Street 1:27 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ELBA
Practice Address - State:NY
Practice Address - Zip Code:14058-9764
Practice Address - Country:US
Practice Address - Phone:585-757-2317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist