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Individual

DR. LINDA M BACON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
595 WILLOUGHBY AVE, BROOKLYN, NY 11206-6811
(917) 667-8069
Mailing address
595 WILLOUGHBY AVE, BROOKLYN, NY 11206-6811
(917) 667-8069

Taxonomy

Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
173690
NY
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
173690
NY

Other

Enumeration date
10/02/2013
Last updated
10/02/2013
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