Healthcare Provider Details

I. General information

NPI: 1558420935
Provider Name (Legal Business Name): LYNN CALAT N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 11/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 55TH ST SUNSET PARK FAMILY HEALTH CENTER
BROOKLYN NY
11220-2559
US

IV. Provider business mailing address

1318 AVENUE H MANAGED CARE DEPARTMENT
BROOKLYN NY
11230-2418
US

V. Phone/Fax

Practice location:
  • Phone: 718-630-7942
  • Fax:
Mailing address:
  • Phone: 718-434-0081
  • Fax: 718-504-7630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number420330
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: