Healthcare Provider Details

I. General information

NPI: 1336848837
Provider Name (Legal Business Name): LINDSAY PRINCER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 W PALISADE AVE
ENGLEWOOD NJ
07631-2705
US

IV. Provider business mailing address

155 E 31ST ST APT 26B
NEW YORK NY
10016-6873
US

V. Phone/Fax

Practice location:
  • Phone: 516-712-7501
  • Fax:
Mailing address:
  • Phone: 516-712-7501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number029635
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: