MEDICARE: ADVANCED ACCESS MEDICAL CARE, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2085R0204X	Vascular & Interventional Radiology Physician
2	2086S0129X	Vascular Surgery Physician
3	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1689014987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED ACCESS MEDICAL CARE, PLLC

Provider Business Mailing Address
First Line	:	1200 WATERS PL
Second Line	:	SUITE M104
City	:	BRONX
State	:	NY
Zip	:	10461-2728
Country	:	US
Telephone Number	:	718-794-1200
Fax Number	:	718-794-1222

Provider Business Practice Location Address
First Line	:	1733 EASTCHESTER RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2315
Country	:	US
Telephone Number	:	516-551-6317
Fax Number	:

Authorized Official
Title or Position	:	SHARE HOLDER
Name	:	DR. ROBERT LYNN
Credential	:	MD
Telephone Number	:	516-551-6317

Provider Enumeration Date	:	07/01/2013
Last Update Date	:	10/29/2013

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