Active NPI
Mary A. Lynch, PH.D.
- Psychologist
- Hauppauge, NY
National Provider Identifier
1376640623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 009154
- Practice address
- 900 Route 111
Suite 210
Hauppauge, NY 11788 - Phone
- (631) 560-2482
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 009154 | NY | Primary |
Addresses
Primary practice location
900 Route 111
Suite 210
Hauppauge, NY 11788
Mailing address
900 Route 111
Suite 210
Hauppauge, NY 11788
Phone (631) 560-2482
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01044251 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009154 | NY | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251072000000",
"number": "1376640623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 ROUTE 111",
"address_2": "SUITE 210",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "11788",
"telephone_number": "631-560-2482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 ROUTE 111",
"address_2": "SUITE 210",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "11788",
"telephone_number": "631-560-2482"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNCH",
"first_name": "MARY",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2009-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "009154",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01044251",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hauppauge, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.