Provider Demographics
NPI:1194077321
Name:LYNCH, ANNMARIE KATELYN (PA-C)
Entity type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:KATELYN
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 SYDNEY ST APT 3
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-1304
Mailing Address - Country:US
Mailing Address - Phone:518-209-8780
Mailing Address - Fax:
Practice Address - Street 1:146 DEAN ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2716
Practice Address - Country:US
Practice Address - Phone:518-209-8780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant