Provider Demographics
NPI:1508071275
Name:PADOVANI, LYNN MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:PADOVANI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:MARIE
Other - Last Name:DALY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:25 ALBION OVAL WEST
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10544
Mailing Address - Country:US
Mailing Address - Phone:845-222-8209
Mailing Address - Fax:
Practice Address - Street 1:25 ALBION OVAL WEST
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10544
Practice Address - Country:US
Practice Address - Phone:845-222-8209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012671174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist