Healthcare Provider Details

I. General information

NPI: 1952384687
Provider Name (Legal Business Name): LYNNE JENNIFER NUGENT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LYNNE JENNIFER SILVER MD

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 BETHLEHEM PK
SPRINGHOUSE PA
19477
US

IV. Provider business mailing address

PO BOX 260
SPRINGHOUSE PA
19477
US

V. Phone/Fax

Practice location:
  • Phone: 215-646-0486
  • Fax: 215-646-9362
Mailing address:
  • Phone: 215-646-0486
  • Fax: 215-646-9362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD0543191L
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: