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General NPI Number Information
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NPI Number | 1073551537
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Entity Type | Individual
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Provider Name | LINDA ANNE SHOOKSTER M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 625 E FORDHAM RD
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City | BRONX
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State | NY
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Zip | 10458-5049
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Country | US
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Telephone | 718-933-1900
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Fax | 718-563-4039
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Provider Business Mailing Address
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Address Line | 524 OLD COUNTRY RD
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City | PLAINVIEW
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State | NY
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Zip | 11803-6502
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Country | US
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Telephone | 516-931-3988
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Fax | 516-931-4091
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 157966
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License Number State | NY
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