Healthcare Provider Details

I. General information

NPI: 1508829078
Provider Name (Legal Business Name): ELIZABETH A. LYNCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LITTLE RIVER RD
KINGSTON NH
03848-3117
US

IV. Provider business mailing address

1 LITTLE RIVER RD
KINGSTON NH
03848-3117
US

V. Phone/Fax

Practice location:
  • Phone: 603-347-8810
  • Fax: 603-347-8811
Mailing address:
  • Phone: 603-347-8810
  • Fax: 603-347-8811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number12172
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number12172
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: