Individual
LINDA IDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
870 SOUTHERN BLVD APT 1A, BRONX, NY 10459-4526
(646) 942-6825
Mailing address
870 SOUTHERN BLVD APT 1A, BRONX, NY 10459-4526
(646) 942-6825
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
686808
NY
Other
Enumeration date
10/06/2014
Last updated
10/06/2014
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