MEDICARE: LYNN PUPEK HAD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	17001366A	IN

General Provider Information

NPI Number	:	1053884239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN PUPEK HAD

Provider Business Mailing Address
First Line	:	3319 E 78TH PL
Second Line	:
City	:	MERRILLVILLE
State	:	IN
Zip	:	46410-4938
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	551 E 4TH ST
Second Line	:
City	:	HOBART
State	:	IN
Zip	:	46342-4423
Country	:	US
Telephone Number	:	219-942-8881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2019
Last Update Date	:	06/11/2019

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Directions to “ LYNN PUPEK HAD” Practice Location

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