Provider Demographics
NPI:1023250180
Name:MOTASIS, LYNN (DPM)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:MOTASIS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 RACE TRACK RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3740
Mailing Address - Country:US
Mailing Address - Phone:732-970-4580
Mailing Address - Fax:732-955-6664
Practice Address - Street 1:51 RACE TRACK RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3740
Practice Address - Country:US
Practice Address - Phone:732-970-4580
Practice Address - Fax:732-955-6664
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-03
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00207800213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery