MEDICARE: DR. LYNN ANNE FINNEGAN O.D.

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	152W00000X	Optometrist	T0005107	NY

General Provider Information

NPI Number	:	1679579189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNN ANNE FINNEGAN O.D.

Provider Business Mailing Address
First Line	:	2 VACATION CT
Second Line	:
City	:	HOLBROOK
State	:	NY
Zip	:	11741-1614
Country	:	US
Telephone Number	:	631-471-9710
Fax Number	:

Provider Business Practice Location Address
First Line	:	NORTHPORT VAMC-OPTOMETRY SERVICE
Second Line	:	79 MIDDLEVILE RD
City	:	NORTHPORT
State	:	NY
Zip	:	11768-2200
Country	:	US
Telephone Number	:	631-261-4400
Fax Number	:

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	07/08/2007

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