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General NPI Number Information
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NPI Number | 1568866697
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Entity Type | Organization
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Legal Business Name | LINDA HALL LPN
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 166 NEIGHBORHOOD RD
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City | MASTIC BEACH
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State | NY
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Zip | 11951-3911
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Country | US
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Telephone | 631-655-7719
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Fax |
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Provider Business Mailing Address
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Address Line | 166 NEIGHBORHOOD RD
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City | MASTIC BEACH
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State | NY
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Zip | 11951-3911
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Country | US
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Telephone | 631-655-7719
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MRS. LINDA SADE HALL
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Credential |
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Telephone | 631-655-7719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | 303395-1
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License Number State | NY
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