Provider Demographics
NPI:1497017172
Name:LYNCH, HOLLY ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:ELIZABETH
Last Name:LYNCH
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:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-0421
Mailing Address - Country:US
Mailing Address - Phone:917-485-1321
Mailing Address - Fax:866-398-5594
Practice Address - Street 1:56 JUNE RD
Practice Address - Street 2:
Practice Address - City:NORTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10560-1702
Practice Address - Country:US
Practice Address - Phone:917-485-1321
Practice Address - Fax:866-398-5594
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist