Healthcare Provider Details

I. General information

NPI: 1750566873
Provider Name (Legal Business Name): CRAIG LINDER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 OCEAN AVENUE
MASSAPEQUA NY
11758-4605
US

IV. Provider business mailing address

514 OCEAN AVENUE
MASSAPEQUA NY
11758-4605
US

V. Phone/Fax

Practice location:
  • Phone: 516-799-2554
  • Fax: 516-799-4570
Mailing address:
  • Phone: 516-799-2554
  • Fax: 516-799-4570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number157466
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MRS. VALERIE S ALLBRIGHT
Title or Position: CPC
Credential: CPC
Phone: 576-616-4982