Individual
LYNN A O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1000 E GENESEE ST, SUITE 300, SYRACUSE, NY 13210-1892
(315) 471-1044
(315) 474-4312
Mailing address
1000 E GENESEE ST, SUITE 300, SYRACUSE, NY 13210-1892
(315) 471-1044
(315) 474-4312
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
335960
NY
363L00000X
Nurse Practitioner
F335960
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F335960
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03121299
—
NY
01
—
335960
LICENSE
NY
Enumeration date
06/24/2009
Last updated
11/11/2010
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