Provider Demographics
NPI:1851362016
Name:LYNCH, MARK P (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:P
Last Name:LYNCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 SERPENTINE DR
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-3227
Mailing Address - Country:US
Mailing Address - Phone:732-269-2225
Mailing Address - Fax:732-237-9825
Practice Address - Street 1:222 SERPENTINE DR
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-3227
Practice Address - Country:US
Practice Address - Phone:732-269-2225
Practice Address - Fax:732-237-9825
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03550111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0418706000OtherAMERIHEALTH
NJP826862OtherOXFORD
NJT88973Medicare UPIN
NJ0418706000OtherAMERIHEALTH