Healthcare Provider Details

I. General information

NPI: 1780638569
Provider Name (Legal Business Name): LINDA RIMKUNOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 03/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 COLDBROOK RD
SOUTH GLASTONBURY CT
06073-3601
US

IV. Provider business mailing address

728 COLDBROOK RD
SOUTH GLASTONBURY CT
06073-3601
US

V. Phone/Fax

Practice location:
  • Phone: 860-657-8044
  • Fax:
Mailing address:
  • Phone: 860-657-8044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD00028833
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00028833
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: