Healthcare Provider Details

I. General information

NPI: 1275592107
Provider Name (Legal Business Name): LINDA KATZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1783 ROUTE 9 STE 203
HALFMOON NY
12065-2466
US

IV. Provider business mailing address

711 TROY SCHENECTADY RD SUITE 203
LATHAM NY
12110-2442
US

V. Phone/Fax

Practice location:
  • Phone: 518-213-6910
  • Fax: 518-213-6932
Mailing address:
  • Phone: 518-782-3700
  • Fax: 518-782-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF334861
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: