Basic Information
Provider Information
NPI: 1902225881
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LYNCH
FirstName: BARBARA
MiddleName: JOY
NamePrefix: MS.
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 107 WEST 4TH STREET
Address2: MOUNT VERNON NEIGHBORHOOD HEALTH CENTER
City: MOUNT VERNON
State: NY
PostalCode: 105504002
CountryCode: US
TelephoneNumber: 9146997200
FaxNumber: 9176990837
Practice Location
Address1: 107 WEST 4TH STREET
Address2: MOUNT VERNON NEIGHBORHOOD HEALTH CENTER
City: MOUNT VERNON
State: NY
PostalCode: 105504002
CountryCode: US
TelephoneNumber: 9146997200
FaxNumber: 9176990837
Other Information
ProviderEnumerationDate: 04/08/2014
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XF338642NYN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000X338642NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

ID Information
IDTypeStateIssuerDescription
0416503705NY MEDICAID


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