Healthcare Provider Details

I. General information

NPI: 1194034801
Provider Name (Legal Business Name): MARTHA F. LINDER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARTHA FREEBORN LINDER

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 02/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 NORTH STREET, SUITE #4 D/B/A AUBURN OBSTETRICS & GYNECOLOGY
AUBURN NY
13021-1983
US

IV. Provider business mailing address

17 LANSING ST ATTN: C. MILLER
AUBURN NY
13021-1983
US

V. Phone/Fax

Practice location:
  • Phone: 315-252-5028
  • Fax: 315-252-1587
Mailing address:
  • Phone: 315-255-7438
  • Fax: 315-255-7099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number001408
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: