Individual
LYNNANN PFAUTSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
51 STACKYARD DR, MASTIC BEACH, NY 11951-1407
(631) 772-2098
Mailing address
51 STACKYARD DR, MASTIC BEACH, NY 11951-1407
(631) 772-2098
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
567739-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02868995
—
NY
Enumeration date
09/04/2008
Last updated
09/04/2008
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