Healthcare Provider Details

I. General information

NPI: 1578555124
Provider Name (Legal Business Name): THOMAS LYNCH CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HIGHLAND AVE LEWISTOWN HOSPITAL
LEWISTOWN PA
17044-1167
US

IV. Provider business mailing address

43 KENSICO DR 2ND FLOOR
MOUNT KISCO NY
10549-1009
US

V. Phone/Fax

Practice location:
  • Phone: 717-248-5411
  • Fax:
Mailing address:
  • Phone: 914-666-8866
  • Fax: 914-666-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN193706
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: