=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508071028
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HOWARD DAVID LINDER M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2007
-----------------------------------------------------
Last Update Date | 03/03/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 COMMUNITY DRIVE NORTH SHORE UNIVERSITY HOSPITAL
-----------------------------------------------------
City | MANHASSET
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11030
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-562-4745
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 260-01 74TH AVE SECOND FLOOR
-----------------------------------------------------
City | GLEN OAKS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-426-5514
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0015X
-----------------------------------------------------
Taxonomy Name | Psychosomatic Medicine Physician
-----------------------------------------------------
License Number | 244207
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------