Healthcare Provider Details

I. General information

NPI: 1578358198
Provider Name (Legal Business Name): LYNNLEE REESE DUCK-REYNOLDS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 04/14/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MANOR PL
GREENPORT NY
11944-1222
US

IV. Provider business mailing address

44 LAMPLIGHT CIR UNIT 4044
HAMPTON BAYS NY
11946-3906
US

V. Phone/Fax

Practice location:
  • Phone: 631-444-6270
  • Fax:
Mailing address:
  • Phone: 760-707-6111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: