Provider Demographics
NPI:1548227903
Name:BIRNBAUM, LYNETTE M (MD)
Entity Type:Individual
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First Name:LYNETTE
Middle Name:M
Last Name:BIRNBAUM
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Gender:F
Credentials:MD
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Mailing Address - Street 1:124 MAIN ST
Mailing Address - Street 2:SUITE1
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6922
Mailing Address - Country:US
Mailing Address - Phone:631-423-0044
Mailing Address - Fax:631-423-0668
Practice Address - Street 1:124 MAIN ST
Practice Address - Street 2:SUITE1
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6922
Practice Address - Country:US
Practice Address - Phone:631-423-0044
Practice Address - Fax:631-423-0668
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY228471-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics