Provider Demographics
NPI:1982723524
Name:LYNCH, DENNIS (PA)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:LYNCH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 BROADHOLLOW RD
Mailing Address - Street 2:SUITE 142
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-3672
Mailing Address - Country:US
Mailing Address - Phone:516-931-0041
Mailing Address - Fax:
Practice Address - Street 1:535 PLANDOME RD
Practice Address - Street 2:SUITE 3
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-1974
Practice Address - Country:US
Practice Address - Phone:516-627-6188
Practice Address - Fax:516-627-9397
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY000341363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical