Individual
LINCY SIMON THADATHIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3330
(631) 968-3690
Mailing address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3330
(631) 968-3690
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
296701
NY
208100000X
Physical Medicine & Rehabilitation Physician
R5480
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2014
Last updated
09/12/2022
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