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NPI Code Detail

MEDICARE: DR. JOHN HERBERT LYNCH M.D., PH.D.

MEDICARE: DR. JOHN HERBERT LYNCH M.D., PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician205057NY
22084P0804XChild & Adolescent Psychiatry Physician205057NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1205057OTHERNYSTATE LICENSE NUMBER

General Provider Information

NPI Number : 1518186303
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN HERBERT LYNCH M.D., PH.D.
Provider Business Mailing Address
First Line : 1183 MONROE AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-1662
Country : US
Telephone Number : 585-256-7926
Fax Number :
Provider Business Practice Location Address
First Line : 1183 MONROE AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-1662
Country : US
Telephone Number : 585-256-7926
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 03/07/2023

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