Provider Demographics
NPI:1598154973
Name:JAMES LYNCH FAMILY NURSE PRACTITIONER PLLC
Entity Type:Organization
Organization Name:JAMES LYNCH FAMILY NURSE PRACTITIONER PLLC
Other - Org Name:LYNCH FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:585-289-9282
Mailing Address - Street 1:1779 STATE ROUTE 21
Mailing Address - Street 2:
Mailing Address - City:SHORTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14548-9718
Mailing Address - Country:US
Mailing Address - Phone:585-289-9282
Mailing Address - Fax:585-289-2704
Practice Address - Street 1:1779 STATE ROUTE 21
Practice Address - Street 2:
Practice Address - City:SHORTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14548
Practice Address - Country:US
Practice Address - Phone:585-289-9282
Practice Address - Fax:585-289-2074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY339233261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care