Healthcare Provider Details

I. General information

NPI: 1306000278
Provider Name (Legal Business Name): LINDA FLYNTZ RUBIN MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA M FLYNTZ CCC-SLP

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 01/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EUGENE L BROWN DR
NEW PALTZ NY
12561-3942
US

IV. Provider business mailing address

PO BOX 207
BOICEVILLE NY
12412-0207
US

V. Phone/Fax

Practice location:
  • Phone: 845-255-4274
  • Fax:
Mailing address:
  • Phone: 845-657-4305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number010636-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: