Michael Lynch, M.D.

Individual provider Active NPI Family Medicine Physician · Granville, NY

NPI 1558697607 · NPPES record last updated Oct 26, 2009

Key facts

NPI
1558697607
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
079066 (NY)
Practice address
19 Quaker St
Granville, NY 12832-1523
Phone
(518) 642-2872
NPI assigned
Oct 26, 2009
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
079066NYMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 079066 NY Yes

Addresses

Primary practice location

19 Quaker St
Granville, NY 12832-1523

Mailing address

19 Quaker St
Granville, NY 12832-1523
Phone (518) 642-2872

Other identifiers

IdentifierTypeStateIssuer
079066OtherNYNYS LISC

Other providers in Granville, NY

All providers in Granville, NY · Family Medicine Physician in New York

Sources for this page

Verify at the official NPI Registry.