Provider Demographics
NPI:1306855911
Name:WASSERBAUER, LYNN IRENE (PHD,FNP,CNS)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:IRENE
Last Name:WASSERBAUER
Suffix:
Gender:F
Credentials:PHD,FNP,CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 WEBSTER RD
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-1527
Mailing Address - Country:US
Mailing Address - Phone:585-734-5060
Mailing Address - Fax:
Practice Address - Street 1:STRONG MEMORIAL HOSPITAL 300 CRITTENDEN BLVD
Practice Address - Street 2:BOX PYCH
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-276-6900
Practice Address - Fax:585-273-1066
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332659-1363LF0000X
NY382148-1364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult