Provider Demographics
NPI:1407127020
Name:COYSH, LYNDA JOAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:JOAN
Last Name:COYSH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 6TH AVE
Mailing Address - Street 2:SONDERLING HS
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-5006
Mailing Address - Country:US
Mailing Address - Phone:631-434-2481
Mailing Address - Fax:631-434-2418
Practice Address - Street 1:2 6TH AVE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-6110
Practice Address - Country:US
Practice Address - Phone:631-434-2481
Practice Address - Fax:631-434-2418
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY285446-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool