Individual
MARY T LYNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA
Contact information
Practice address
4101 MEDICAL CENTER DR, FAYETTEVILLE, NY 13066-6600
(315) 637-7800
(315) 637-7800
Mailing address
4101 MEDICAL CENTER DR, FAYETTEVILLE, NY 13066-6600
(315) 637-7800
(315) 637-7800
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006876
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J400002702
PTAN#
NY
Enumeration date
03/28/2006
Last updated
10/09/2009
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