Healthcare Provider Details

I. General information

NPI: 1548879109
Provider Name (Legal Business Name): LINDA ANN PARADISO DNP, RN, NPP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 07/29/2020
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 JAY ST # A611M
BROOKLYN NY
11201-1909
US

IV. Provider business mailing address

386 OAKLAND AVE
STATEN ISLAND NY
10310-2133
US

V. Phone/Fax

Practice location:
  • Phone: 718-260-5129
  • Fax:
Mailing address:
  • Phone: 917-710-7730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number345702
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: