Provider Demographics
NPI:1609935501
Name:LYNCH, PHILLIP IRVING JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:IRVING
Last Name:LYNCH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4 ST JOHNS PARKWAY
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-486-1021
Mailing Address - Fax:
Practice Address - Street 1:45 READE PLACE
Practice Address - Street 2:VASSAR BROTHERS MEDICAL CENTER DEPT OF PATHOLOGY
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-431-5618
Practice Address - Fax:845-437-3170
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145296207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B77B43Medicare UPIN
36E902Medicare ID - Type Unspecified