Healthcare Provider Details

I. General information

NPI: 1780590141
Provider Name (Legal Business Name): LINDA SUPINSKI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 KINNELON RD
KINNELON NJ
07405-2707
US

IV. Provider business mailing address

214 KINNELON RD
KINNELON NJ
07405-2707
US

V. Phone/Fax

Practice location:
  • Phone: 914-299-3311
  • Fax:
Mailing address:
  • Phone: 914-299-3311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15632700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: