MEDICARE: BRIAN P. LYNN DPM

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	213E00000X	Podiatrist	N005264-1	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
16	480033366	OTHER	NY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0914058	OTHER	NY	AETNA HMO
2	10000253206	OTHER	NY	AFFINITY
3	PG6691	OTHER	NY	EMPIRE BCBS
4	1175537	OTHER	NY	FIRST HEALTH
5	21215922460	OTHER	NY	BEECH ST
6	N0052641-A14	OTHER	NY	HEALTH FIRST
7	P2577825	OTHER	NY	OXFORD
8	108081P	OTHER	NY	HIP
9	1499715	OTHER	NY	GHI
10	171714	OTHER	NY	ELDER PLAN
11	2428938-007	OTHER	NY	CIGNA
12	030002342NJ01	OTHER	NY	ANTHEM
13	4C1454	OTHER	NY	HEALTH NET
14	AA71987	OTHER	NY	MDNY
15	005707438	OTHER	NY	AETNA PPO

General Provider Information

NPI Number	:	1568573319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN P. LYNN DPM

Provider Business Mailing Address
First Line	:	935 NORTHERN BLVD
Second Line	:	SUITE 107
City	:	GREAT NECK
State	:	NY
Zip	:	11021-5309
Country	:	US
Telephone Number	:	516-627-5775
Fax Number	:	516-627-6259

Provider Business Practice Location Address
First Line	:	935 NORTHERN BLVD
Second Line	:	SUITE 107
City	:	GREAT NECK
State	:	NY
Zip	:	11021-5309
Country	:	US
Telephone Number	:	516-627-5775
Fax Number	:	516-627-6259

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	02/12/2026

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