MEDICARE: LINDA MOERCK DO

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	207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician	213068	NY

General Provider Information

NPI Number	:	1487784849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA MOERCK DO

Provider Business Mailing Address
First Line	:	1014 FORT SALONGA RD
Second Line	:
City	:	NORTHPORT
State	:	NY
Zip	:	11768-2208
Country	:	US
Telephone Number	:	631-757-5604
Fax Number	:

Provider Business Practice Location Address
First Line	:	1014 FORT SALONGA RD
Second Line	:
City	:	NORTHPORT
State	:	NY
Zip	:	11768-2208
Country	:	US
Telephone Number	:	631-757-5604
Fax Number	:

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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Directions to “ LINDA MOERCK DO” Practice Location

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