Provider Demographics
NPI:1134376007
Name:LYNCH, MARY LEE (RN,MSN,CS)
Entity type:Individual
Prefix:MS
First Name:MARY LEE
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:RN,MSN,CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PURITAN WOODS RD
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-1982
Mailing Address - Country:US
Mailing Address - Phone:914-921-6971
Mailing Address - Fax:
Practice Address - Street 1:275 NORTH ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1524
Practice Address - Country:US
Practice Address - Phone:914-925-5305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145645101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY145645OtherREGISTERED NURSE