Provider Demographics
NPI:1750649968
Name:YUDOFSKY, LYNN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:MARIE
Last Name:YUDOFSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 QUARRY ROAD
Mailing Address - Street 2:MC5718
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-723-4000
Mailing Address - Fax:
Practice Address - Street 1:401 QUARRY ROAD
Practice Address - Street 2:MC 5718
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1305962084N0400X, 2084N0400X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology