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General NPI Number Information
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NPI Number | 1972488971
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Entity Type | Individual
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Provider Name | KEVIN ROBERT LYNN PSY D.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 1973 ROUTE 34 STE 102
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City | WALL TOWNSHIP
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State | NJ
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Zip | 07719-9732
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Country | US
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Telephone | 732-927-1862
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Fax |
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Provider Business Mailing Address
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Address Line | 13 CLEARVIEW RD
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-4254
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Country | US
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Telephone | 732-735-8933
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Fax | 732-735-8933
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 253041
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License Number State | NJ
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