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General NPI Number Information
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NPI Number | 1952563850
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Entity Type | Individual
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Provider Name | LINDA ANN BOMBOLINO RN
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Gender | Female
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 20 COMMUNITY LN
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City | LIBERTY
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State | NY
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Zip | 12754-2851
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Country | US
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Telephone | 845-292-8770
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Fax | 845-292-4298
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Provider Business Mailing Address
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Address Line | 5 CEDAR PARK COMMONS #17
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City | MONTICELLO
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State | NY
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Zip | 12701-2585
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Country | US
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Telephone | 845-794-1916
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 233761-1
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License Number State | NY
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