Provider Demographics
NPI:1659150597
Name:LYNCH, TENNESHA
Entity Type:Individual
Prefix:
First Name:TENNESHA
Middle Name:
Last Name:LYNCH
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 1:935 WHITE PLAINS RD STE 203B
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4547
Mailing Address - Country:US
Mailing Address - Phone:203-616-2255
Mailing Address - Fax:203-504-9639
Practice Address - Street 1:935 WHITE PLAINS RD STE 203B
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4547
Practice Address - Country:US
Practice Address - Phone:203-616-2255
Practice Address - Fax:203-504-9639
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0002269372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion