Provider Demographics
NPI:1770751489
Name:DWYER, LYN MARIE (RPH)
Entity type:Individual
Prefix:MS
First Name:LYN MARIE
Middle Name:
Last Name:DWYER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 BENEDICT AVE
Mailing Address - Street 2:UNIT 4E
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-4942
Mailing Address - Country:US
Mailing Address - Phone:914-332-6361
Mailing Address - Fax:914-332-6361
Practice Address - Street 1:725 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-1811
Practice Address - Country:US
Practice Address - Phone:914-693-9191
Practice Address - Fax:914-693-1231
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046352-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist