MEDICARE: LINDA A PRESTON LPN

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	164W00000X	Licensed Practical Nurse	276701-1	NY

General Provider Information

NPI Number	:	1932365715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA A PRESTON LPN

Provider Business Mailing Address
First Line	:	756 ENFIELD FALLS RD
Second Line	:
City	:	NEWFIELD
State	:	NY
Zip	:	14867-9250
Country	:	US
Telephone Number	:	607-272-0896
Fax Number	:

Provider Business Practice Location Address
First Line	:	756 ENFIELD FALLS RD
Second Line	:
City	:	NEWFIELD
State	:	NY
Zip	:	14867-9250
Country	:	US
Telephone Number	:	607-272-0896
Fax Number	:

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

Provider Enumeration Date	:	08/01/2008
Last Update Date	:	08/01/2008

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Directions to “ LINDA A PRESTON LPN” Practice Location

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