Provider Demographics
NPI:1811023294
Name:ISERNIA, LYNN EVERETT (PT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:EVERETT
Last Name:ISERNIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:250 OLD LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2909
Mailing Address - Country:US
Mailing Address - Phone:518-489-2020
Mailing Address - Fax:518-489-0716
Practice Address - Street 1:250 OLD LOUDON RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2909
Practice Address - Country:US
Practice Address - Phone:518-690-4406
Practice Address - Fax:518-220-9220
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2023-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY014534225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist