Healthcare Provider Details

I. General information

NPI: 1598728305
Provider Name (Legal Business Name): LYNETTE HACKETTE POSORSKE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8630 FENTON STREET SUITE 700
SILVER SPRING MD
20910
US

IV. Provider business mailing address

8630 FENTON STREET SUITE 700
SILVER SPRING MD
20910
US

V. Phone/Fax

Practice location:
  • Phone: 301-588-2525
  • Fax: 301-588-3447
Mailing address:
  • Phone: 301-588-2525
  • Fax: 301-587-3636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberD0043228
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier753131100
Identifier TypeMEDICAID
Identifier StateMD
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: