Healthcare Provider Details

I. General information

NPI: 1164707741
Provider Name (Legal Business Name): LINDA H. ALBERT, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2011
Last Update Date: 10/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 OLD NYACK TPKE SUITE 207
NANUET NY
10954-2461
US

IV. Provider business mailing address

55 OLD NYACK TPKE SUITE 207
NANUET NY
10954-2461
US

V. Phone/Fax

Practice location:
  • Phone: 845-624-5134
  • Fax: 845-624-5135
Mailing address:
  • Phone: 845-624-5134
  • Fax: 845-624-5135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number168128
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number168128
License Number StateNY

VIII. Authorized Official

Name: DR. LINDA H ALBERT
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 845-624-5134