Provider Demographics
NPI:1568573319
Name:LYNN, BRIAN P (DPM)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:P
Last Name:LYNN
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:935 NORTHERN BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5309
Mailing Address - Country:US
Mailing Address - Phone:516-627-5775
Mailing Address - Fax:516-627-6259
Practice Address - Street 1:935 NORTHERN BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5309
Practice Address - Country:US
Practice Address - Phone:516-627-5775
Practice Address - Fax:516-627-6259
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2017-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYN005264-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0914058OtherAETNA HMO
NY10000253206OtherAFFINITY
NYPG6691OtherEMPIRE BCBS
NY1175537OtherFIRST HEALTH
NY21215922460OtherBEECH ST
NYN0052641-A14OtherHEALTH FIRST
NYP2577825OtherOXFORD
NY108081POtherHIP
NY1499715OtherGHI
NY171714OtherELDER PLAN
NY2428938-007OtherCIGNA
NY030002342NJ01OtherANTHEM
NY4C1454OtherHEALTH NET
NYAA71987OtherMDNY
NY005707438OtherAETNA PPO
NY480033366OtherRAILROAD MEDICARE
NY171714OtherELDER PLAN
NY030002342NJ01OtherANTHEM
NYP2577825OtherOXFORD
NY1175537OtherFIRST HEALTH
NY1499715OtherGHI