Provider Demographics
NPI:1689342990
Name:DUNN, LINCOLN GABRIEL (AUD)
Entity type:Individual
Prefix:DR
First Name:LINCOLN
Middle Name:GABRIEL
Last Name:DUNN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 WHITEHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:HARTWICK
Mailing Address - State:NY
Mailing Address - Zip Code:13348-2526
Mailing Address - Country:US
Mailing Address - Phone:774-452-2410
Mailing Address - Fax:
Practice Address - Street 1:1 ATWELL RD
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1301
Practice Address - Country:US
Practice Address - Phone:607-547-3189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003061231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist