Provider Demographics
NPI:1255608394
Name:ANNE H. LYNN, M.S., AUDIOLOGIST, LLC
Entity type:Organization
Organization Name:ANNE H. LYNN, M.S., AUDIOLOGIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-364-0634
Mailing Address - Street 1:1 SHADOW RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1060
Mailing Address - Country:US
Mailing Address - Phone:203-364-0634
Mailing Address - Fax:203-364-8546
Practice Address - Street 1:107 CHURCH HILL RD
Practice Address - Street 2:2 E
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482-1108
Practice Address - Country:US
Practice Address - Phone:203-304-9744
Practice Address - Fax:203-304-9745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT185332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004208155Medicaid
CT004208155Medicaid