Provider Demographics
NPI:1831238393
Name:GAETANO, LYNN (DPT)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:GAETANO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5982
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23471-0982
Mailing Address - Country:US
Mailing Address - Phone:757-228-5201
Mailing Address - Fax:757-456-5031
Practice Address - Street 1:762 INDEPENDENCE BLVD
Practice Address - Street 2:#772
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6200
Practice Address - Country:US
Practice Address - Phone:757-456-2032
Practice Address - Fax:757-456-5031
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist