Provider Demographics
NPI:1851953210
Name:LYNCH, DONALD L JR
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:L
Last Name:LYNCH
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 BARTLAM AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-1809
Mailing Address - Country:US
Mailing Address - Phone:216-401-3802
Mailing Address - Fax:
Practice Address - Street 1:4750 BARTLAM AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-1809
Practice Address - Country:US
Practice Address - Phone:216-401-3802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator