Provider Demographics
NPI:1679607352
Name:MORGENSTERN, LYNN M (PA-C)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:MORGENSTERN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 LARK LANE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2818
Mailing Address - Country:US
Mailing Address - Phone:856-427-9639
Mailing Address - Fax:
Practice Address - Street 1:1904 LARK LN
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2919
Practice Address - Country:US
Practice Address - Phone:856-427-9639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NC001002058363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
2766553OtherUNITED HEALTHCARE
3K6379OtherHEALTHNET
45572OtherUNIVERSITY HEALTHPLAN
NJMP00173400OtherSTAE LICENSE
NJ110811 AVVMedicare PIN