Basic Information
Provider Information
NPI: 1386237279
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LYNCH
FirstName: KARLI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
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Mailing Information
Address1: 1377 MOTOR PKWY STE 307
Address2:  
City: ISLANDIA
State: NY
PostalCode: 117495258
CountryCode: US
TelephoneNumber: 9142944050
FaxNumber: 6317608306
Practice Location
Address1: 8015 FRANKFORD AVE
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191362736
CountryCode: US
TelephoneNumber: 2153388900
FaxNumber: 2153388923
Other Information
ProviderEnumerationDate: 02/11/2021
LastUpdateDate: 02/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT029282PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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