Provider Demographics
NPI:1992775670
Name:WOJTYSIAK, LYNN A (PAC)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:A
Last Name:WOJTYSIAK
Suffix:
Gender:F
Credentials:PAC
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Mailing Address - Street 1:520 UPPER CHESAPEAKE DRIVE #201
Mailing Address - Street 2:UPPER CHESAPEAKE CARDIOLOGY, LLC
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4360
Mailing Address - Country:US
Mailing Address - Phone:410-893-3122
Mailing Address - Fax:410-893-0483
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4339
Practice Address - Country:US
Practice Address - Phone:410-893-3122
Practice Address - Fax:410-893-0483
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
50002049363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q33872Medicare UPIN