Healthcare Provider Details
I. General information
NPI: 1487636411
Provider Name (Legal Business Name): LINDA J PRESTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 11/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
70 MAIN ST NORTHAMPTON HEALTH CENTER
FLORENCE MA
01062-1466
US
IV. Provider business mailing address
70 MAIN ST NORTHAMPTON HEALTH CENTER
FLORENCE MA
01062-1466
US
V. Phone/Fax
- Phone: 413-586-8400
- Fax: 413-585-5435
- Phone: 413-586-8400
- Fax: 413-585-5435
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 157480 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: