MEDICARE: DR. LINDA KESTENBAUM PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	6005	NY

General Provider Information

NPI Number	:	1124230529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA KESTENBAUM PH.D.

Provider Business Mailing Address
First Line	:	142 W END AVE
Second Line	:	APT. 19N
City	:	NEW YORK
State	:	NY
Zip	:	10023-6103
Country	:	US
Telephone Number	:	212-799-6373
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 W END AVE
Second Line	:	APT. 19N
City	:	NEW YORK
State	:	NY
Zip	:	10023-6103
Country	:	US
Telephone Number	:	212-799-6373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2007
Last Update Date	:	02/01/2015

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