Provider Demographics
NPI:1568804938
Name:LYNCH, MARCIA THERESA (MSED)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:THERESA
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-4715
Mailing Address - Country:US
Mailing Address - Phone:845-671-0919
Mailing Address - Fax:845-574-4950
Practice Address - Street 1:260 OLD NYACK TPKE
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5741
Practice Address - Country:US
Practice Address - Phone:845-574-4950
Practice Address - Fax:845-574-4944
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY504244042174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator