Provider Demographics
NPI:1164919718
Name:GONDECK, LYNN MICHELLE (CPC, MPE)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:MICHELLE
Last Name:GONDECK
Suffix:
Gender:F
Credentials:CPC, MPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 TANYERHYDE DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6519
Mailing Address - Country:US
Mailing Address - Phone:443-244-0318
Mailing Address - Fax:
Practice Address - Street 1:385 TANYERHYDE DR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6519
Practice Address - Country:US
Practice Address - Phone:443-244-0318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor