Provider Demographics
NPI:1275814741
Name:CHAMBERLIN, LYNN B
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:B
Last Name:CHAMBERLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E 77TH ST
Mailing Address - Street 2:#12C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1922
Mailing Address - Country:US
Mailing Address - Phone:212-744-9260
Mailing Address - Fax:
Practice Address - Street 1:150 E 77TH ST
Practice Address - Street 2:#12C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1922
Practice Address - Country:US
Practice Address - Phone:212-744-9260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017226-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist