Healthcare Provider Details

I. General information

NPI: 1164232807
Provider Name (Legal Business Name): LYNDA CHRISTINE VIOLANTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 PARK AVE S
NEW YORK NY
10016-7390
US

IV. Provider business mailing address

3 PINEHURST DR
PURCHASE NY
10577-1010
US

V. Phone/Fax

Practice location:
  • Phone: 212-786-7705
  • Fax:
Mailing address:
  • Phone: 914-393-9167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number355695
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: