Provider Demographics
NPI:1346382124
Name:SAVINO, LYNN ELLEN (PT)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:ELLEN
Last Name:SAVINO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:LYNN
Other - Middle Name:ELLEN
Other - Last Name:BONIECKI-SAVINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:40 MOUNT PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-4815
Mailing Address - Country:US
Mailing Address - Phone:631-863-2150
Mailing Address - Fax:
Practice Address - Street 1:40 MOUNT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-4815
Practice Address - Country:US
Practice Address - Phone:631-863-2150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010855-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist