Provider Demographics
NPI:1548727597
Name:DUFFY, LYNNE S
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:S
Last Name:DUFFY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3250
Mailing Address - Country:US
Mailing Address - Phone:203-874-6270
Mailing Address - Fax:203-874-3301
Practice Address - Street 1:203 HIGH ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3250
Practice Address - Country:US
Practice Address - Phone:203-874-6270
Practice Address - Fax:203-874-3301
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT14012610OtherCATHOLIC CHARITIES ARCHDIOCES OF HARTFORD