Individual
LINDA WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPAC
Contact information
Practice address
815 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1220
(631) 331-7267
Mailing address
22 SILAS WOODS RD, MANORVILLE, NY 11949-3053
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006266-1
NY
Other
Enumeration date
07/21/2006
Last updated
09/16/2014
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