Healthcare Provider Details

I. General information

NPI: 1831921006
Provider Name (Legal Business Name): LINDA CHIWARA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ROE AVE
ELMIRA NY
14905-1676
US

IV. Provider business mailing address

306 FOX TRL
PARKESBURG PA
19365-9197
US

V. Phone/Fax

Practice location:
  • Phone: 607-737-4100
  • Fax:
Mailing address:
  • Phone: 617-970-0291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberN52195
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: