Provider Demographics
NPI:1659608966
Name:LYNCH, WILLIAM PETER (RPA-C)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PETER
Last Name:LYNCH
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 N GREENBUSH RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-8369
Mailing Address - Country:US
Mailing Address - Phone:518-286-3000
Mailing Address - Fax:518-286-3008
Practice Address - Street 1:76 N GREENBUSH RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-8369
Practice Address - Country:US
Practice Address - Phone:518-286-3000
Practice Address - Fax:518-286-3008
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000207363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant