MEDICARE: MS. LINDA LU KAFADER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	067658-1	NY

General Provider Information

NPI Number	:	1376792135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA LU KAFADER

Provider Business Mailing Address
First Line	:	8709 HIGH ST
Second Line	:
City	:	BARKER
State	:	NY
Zip	:	14012-9401
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8709 HIGH ST
Second Line	:
City	:	BARKER
State	:	NY
Zip	:	14012
Country	:	US
Telephone Number	:	716-807-6910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2008
Last Update Date	:	09/16/2008

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