Healthcare Provider Details

I. General information

NPI: 1053369041
Provider Name (Legal Business Name): LINDA BAILEY P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E OLNEY AVE SUITE 400
PHILADELPHIA PA
19120-2421
US

IV. Provider business mailing address

40 NORWYN RD
HATBORO PA
19040-2018
US

V. Phone/Fax

Practice location:
  • Phone: 215-456-7000
  • Fax: 215-254-2599
Mailing address:
  • Phone: 215-456-7000
  • Fax: 215-254-2599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: