Provider Demographics
NPI:1366604308
Name:LOGATTO, LYNNE S (APN)
Entity type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:S
Last Name:LOGATTO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-2356
Mailing Address - Country:US
Mailing Address - Phone:908-464-2276
Mailing Address - Fax:
Practice Address - Street 1:249 UNIVERSITY AVE
Practice Address - Street 2:RUTGERS UNIVERSITY HEALTH SERVICE
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-1896
Practice Address - Country:US
Practice Address - Phone:973-353-5232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN04395000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily