Healthcare Provider Details

I. General information

NPI: 1750638011
Provider Name (Legal Business Name): LINDA A. LEMISZKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2012
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 STATE ST
SCHENECTADY NY
12305-2414
US

IV. Provider business mailing address

504 STATE ST
SCHENECTADY NY
12305-2414
US

V. Phone/Fax

Practice location:
  • Phone: 518-382-3290
  • Fax: 518-382-3398
Mailing address:
  • Phone: 518-382-3290
  • Fax: 518-382-3398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number211865-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: