MEDICARE: MS. LINDA MARY SUDANO NP

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	363L00000X	Nurse Practitioner	332241	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932182383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA MARY SUDANO NP

Provider Business Mailing Address
First Line	:	397 WARDMAN RD
Second Line	:
City	:	KENMORE
State	:	NY
Zip	:	14217-2909
Country	:	US
Telephone Number	:	716-430-5952
Fax Number	:

Provider Business Practice Location Address
First Line	:	3435 MAIN ST
Second Line	:	MICHAEL HALL
City	:	BUFFALO
State	:	NY
Zip	:	14214-3001
Country	:	US
Telephone Number	:	716-829-3316
Fax Number	:

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

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	08/07/2012

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