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NPI Code Detail

MEDICARE: LINDA OBASA

MEDICARE: LINDA OBASA
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
1164W00000XLicensed Practical Nurse295956-1NY

General Provider Information

NPI Number : 1528382710
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA OBASA
Provider Business Mailing Address
First Line : 1523 E 45TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-3003
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13 CLEVELAND ST
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11580-6003
Country : US
Telephone Number : 516-823-0739
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2010
Last Update Date : 03/17/2010

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Directions to “ LINDA OBASA ” Practice Location

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