Provider Demographics
NPI:1386732592
Name:LYNCH, PATRICIA ANN (OD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:LYNCH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7507 GOVERNOR PRINTZ BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-2414
Mailing Address - Country:US
Mailing Address - Phone:302-792-1774
Mailing Address - Fax:
Practice Address - Street 1:419 N MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-3002
Practice Address - Country:US
Practice Address - Phone:302-654-6490
Practice Address - Fax:302-654-9527
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEIE-0001169152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000044422Medicaid
DE901604OtherBLOCK VISION
DE0067233OtherAETNA
DEC11012OtherBLUE CROSS/ BLUE SHIELD
DE0067233OtherAETNA
DEC11012OtherBLUE CROSS/ BLUE SHIELD