Stacie R Lynn, OD is a
Optometrist physician based in Philadelphia, Pennsylvania. Stacie R Lynn is licensed to practice in Pennsylvania (license number OEG002050) and her current practice location is 9863 Busleton Ave, Ste A, Philadelphia, Pennsylvania. She can be reached at her office (for appointments etc.) via phone at
(215) 969-1100.
NPI number for Stacie R Lynn is 1639164247 and her current mailing address is 1425 Sloan Way, Ambler, Pennsylvania. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1639164247.
Physician's Profile
Full Name | Stacie R Lynn |
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Gender | Female |
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Speciality | Optometrist |
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Location | 9863 Busleton Ave, Philadelphia, Pennsylvania |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1639164247
- Provider Enumeration Date: 09/20/2005
- Last Update Date: 03/19/2025
Medical Identifiers
Medical identifiers for Stacie R Lynn such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1639164247 | NPI | - | NPPES |
046009376 | Medicaid | IL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207W00000X | Ophthalmology | 046009376 (Illinois) | Secondary |
152W00000X | Optometrist | OEG002050 (Pennsylvania) | Primary |
152W00000X | Optometrist | 046-009376 (Illinois) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stacie R Lynn is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Stacie R Lynn, OD 1425 Sloan Way, Ambler, PA 19002-1205 Ph: (773) 531-5568 | Stacie R Lynn, OD 9863 Busleton Ave, Ste A, Philadelphia, PA 19115 Ph: (215) 969-1100 |
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