Healthcare Provider Details

I. General information

NPI: 1497818033
Provider Name (Legal Business Name): LYNDA L PREISER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MAIN ST FOREMAN HALL SUNY, DELHI
DELHI NY
13753-1144
US

IV. Provider business mailing address

12 TERRACE AVE
WALTON NY
13856-1431
US

V. Phone/Fax

Practice location:
  • Phone: 607-746-4690
  • Fax: 607-746-4141
Mailing address:
  • Phone: 607-865-5021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number380125
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: