Provider Demographics
NPI:1790744621
Name:BRAUNSTEIN, LYNN (MD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:BRAUNSTEIN
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 1:630 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-5606
Mailing Address - Country:US
Mailing Address - Phone:718-484-9101
Mailing Address - Fax:718-484-9102
Practice Address - Street 1:630 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-5606
Practice Address - Country:US
Practice Address - Phone:718-484-9101
Practice Address - Fax:718-484-9102
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168847207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01309815Medicaid
NY27F151Medicare ID - Type Unspecified
NY01309815Medicaid