Active NPI
Lynn D Wille, ATC/L
- Athletic Trainer
- Garden City, NY
National Provider Identifier
1841284544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 000973
- Practice address
- 1300 Franklin Ave
Suite LL2
Garden City, NY 11530-1886 - Phone
- (516) 663-9099
- Fax
- (516) 663-9092
- NPI assigned
- Sep 8, 2005
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 000973 | NY | Primary |
Addresses
Primary practice location
1300 Franklin Ave
Suite LL2
Garden City, NY 11530-1886
Mailing address
23 Massachusetts Blvd
Floral Park, NY 11001-4138
Phone (516) 328-1331
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000973 | NY | MD | Psychoanalyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410307200000",
"number": "1841284544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 MASSACHUSETTS BLVD",
"city": "FLORAL PARK",
"state": "NY",
"postal_code": "110014138",
"telephone_number": "516-328-1331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 FRANKLIN AVE",
"address_2": "SUITE LL2",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115301886",
"telephone_number": "516-663-9099",
"fax_number": "516-663-9092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLE",
"first_name": "LYNN",
"middle_name": "D",
"name_prefix": "Ms.",
"credential": "ATC/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-08",
"last_updated": "2014-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "000973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.