Provider Demographics
NPI:1881964054
Name:BYRNE, PATRICK R
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:R
Last Name:BYRNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-4725
Mailing Address - Country:US
Mailing Address - Phone:617-909-0721
Mailing Address - Fax:
Practice Address - Street 1:91 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-4725
Practice Address - Country:US
Practice Address - Phone:617-909-0721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator