MEDICARE: LINDA BOONE

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	376K00000X	Nurse's Aide	NY000439035E	NY

General Provider Information

NPI Number	:	1588353486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA BOONE

Provider Business Mailing Address
First Line	:	19 NORWICH DR APT K
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-1244
Country	:	US
Telephone Number	:	585-512-4997
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 NORWICH DR APT K
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-1244
Country	:	US
Telephone Number	:	585-512-4997
Fax Number	:

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

Provider Enumeration Date	:	05/05/2023
Last Update Date	:	05/05/2023

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Directions to “ LINDA BOONE ” Practice Location

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