Provider Demographics
NPI:1780879569
Name:LYNCH, TERESA ELIZABETH
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:ELIZABETH
Last Name:LYNCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WESTMINSTER CT
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-5350
Mailing Address - Country:US
Mailing Address - Phone:908-904-4657
Mailing Address - Fax:908-904-4658
Practice Address - Street 1:12 WESTMINSTER CT
Practice Address - Street 2:
Practice Address - City:BELLE MEAD
Practice Address - State:NJ
Practice Address - Zip Code:08502-5350
Practice Address - Country:US
Practice Address - Phone:908-904-4657
Practice Address - Fax:908-904-4658
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01257100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist