Provider Demographics
NPI:1609834704
Name:LYNCH, MATTHEW J (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:LYNCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300B PRINCETON HIGHTSTOWN ROAD
Mailing Address - Street 2:STE 101
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520
Mailing Address - Country:US
Mailing Address - Phone:609-448-6200
Mailing Address - Fax:609-448-1800
Practice Address - Street 1:300B PRINCETON HIGHTSTOWN ROAD
Practice Address - Street 2:STE 101
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520
Practice Address - Country:US
Practice Address - Phone:609-448-6200
Practice Address - Fax:609-448-1800
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA073726002086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
073124Medicare ID - Type Unspecified
H72429Medicare UPIN