Provider Demographics
NPI:1750922753
Name:LYNCH, ALYSSA JEAN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:JEAN
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1479 YORK AVE APT 3S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-8837
Mailing Address - Country:US
Mailing Address - Phone:774-571-5061
Mailing Address - Fax:
Practice Address - Street 1:21-14 NEWTOWN AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102
Practice Address - Country:US
Practice Address - Phone:718-545-0958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist