Provider Demographics
NPI:1760022339
Name:LYNX IPA LLC
Entity type:Organization
Organization Name:LYNX IPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRYCJA
Authorized Official - Middle Name:
Authorized Official - Last Name:LESNIOWSKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-816-8500
Mailing Address - Street 1:17 VAN NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 CENTRAL PARK W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6055
Practice Address - Country:US
Practice Address - Phone:201-816-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization