Provider Demographics
NPI:1619322583
Name:LYNCE, IRONDA
Entity Type:Individual
Prefix:MS
First Name:IRONDA
Middle Name:
Last Name:LYNCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-2616
Mailing Address - Country:US
Mailing Address - Phone:845-893-2467
Mailing Address - Fax:
Practice Address - Street 1:365 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983
Practice Address - Country:US
Practice Address - Phone:845-893-2467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist