Physician Compare National (NPI:1669490157)

HEALTHCARE PROVIDER: LYNN PAVLIC OD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1669490157
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1850587841
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101202000781
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PAVLIC
	Individual professional last name
Provider First Name	LYNN
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PENNSYLVANIA COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	150 W BEAU ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 112
	Group Practice or individual's line 2 address
City	WASHINGTON
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	153014425
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y