Provider Demographics
NPI:1225160385
Name:SARR, LYNN MARIE (NP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:SARR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CVPH MEDICAL CENTER
Mailing Address - Street 2:75 BEEKMAN ST
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1493
Mailing Address - Country:US
Mailing Address - Phone:518-561-2000
Mailing Address - Fax:518-561-7470
Practice Address - Street 1:CVPH RENAL CENTER
Practice Address - Street 2:91 PLAZA BLVD
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901
Practice Address - Country:US
Practice Address - Phone:518-561-5334
Practice Address - Fax:518-561-7470
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF301790363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00363213Medicaid
NYBLUE SHIELDOther000403613001
NYBLUE SHIELDOther000403613001
NYBLUE SHIELDOther000403613001
NYMS0353590OtherDEA
NY00363213Medicaid