Individual
MR. KEVIN JOHN LYNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN' ASSISTANT
Contact information
Practice address
1418 GENESEE ST, UTICA, NY 13502-5101
(315) 797-0111
(315) 735-3459
Mailing address
PO BOX 8190, UTICA, NY 13505-8190
(315) 797-0111
(315) 735-3459
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
000849
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000849
NYS LICENSE NUMBER
NY
Enumeration date
10/25/2006
Last updated
03/07/2023
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