Healthcare Provider Details

I. General information

NPI: 1023098209
Provider Name (Legal Business Name): LINDA ESTHER BORNSTEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2006
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 MAIN ST
SPRINGFIELD MA
01107-1112
US

IV. Provider business mailing address

3350 MAIN ST
SPRINGFIELD MA
01107-1112
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-9175
  • Fax: 413-794-5153
Mailing address:
  • Phone: 413-794-9175
  • Fax: 413-794-5153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number77372
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: