Provider Demographics
NPI:1275531105
Name:LYNCH, CHRISTINE K (PA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:K
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:85 SEYMOUR ST
Mailing Address - Street 2:STE. 821
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5501
Mailing Address - Country:US
Mailing Address - Phone:860-545-5061
Mailing Address - Fax:860-545-3558
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:STE. 821
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-545-5061
Practice Address - Fax:860-545-3558
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT000033363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP35577Medicare UPIN