Provider Demographics
NPI:1316055494
Name:LYNCH, ANNE M (PA)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1425 PORTLAND AVE
Mailing Address - Street 2:ROCHESTER GENERAL MEDICAL ASSOCIATE - TWIG SITE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3001
Mailing Address - Country:US
Mailing Address - Phone:585-922-4882
Mailing Address - Fax:
Practice Address - Street 1:1425 PORTLAND AVE.
Practice Address - Street 2:ROCHESTER GENERAL MEDICAL ASSOCIATES - TWIG SITE
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621
Practice Address - Country:US
Practice Address - Phone:585-922-4882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY011425363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400013918Medicare PIN