Basic Information
| Provider Information | |||||||||
| NPI: | 1992775670 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | WOJTYSIAK | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 520 UPPER CHESAPEAKE DRIVE #201 | ||||||||
| Address2: | UPPER CHESAPEAKE CARDIOLOGY, LLC | ||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210144360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108933122 | ||||||||
| FaxNumber: | 4108930483 | ||||||||
| Practice Location | |||||||||
| Address1: | 520 UPPER CHESAPEAKE DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210144339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108933122 | ||||||||
| FaxNumber: | 4108930483 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2006 | ||||||||
| LastUpdateDate: | 04/24/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | 50002049 | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.