Healthcare Provider Details

I. General information

NPI: 1548645153
Provider Name (Legal Business Name): LINDA BRUCE F.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2015
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 COMMANDER AVE
HEMPSTEAD NY
11550-1908
US

IV. Provider business mailing address

32 COMMANDER AVE
HEMPSTEAD NY
11550-1908
US

V. Phone/Fax

Practice location:
  • Phone: 516-444-7936
  • Fax:
Mailing address:
  • Phone: 516-444-7936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number703490
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number345501
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: