Provider Demographics
NPI:1073536116
Name:LINDNER, HENRY HUDSON (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:HUDSON
Last Name:LINDNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:230 W TIOGA ST
Mailing Address - Street 2:STE 5
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657-6667
Mailing Address - Country:US
Mailing Address - Phone:570-955-3495
Mailing Address - Fax:570-836-7979
Practice Address - Street 1:230 W TIOGA ST
Practice Address - Street 2:STE 5
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-6667
Practice Address - Country:US
Practice Address - Phone:570-955-3495
Practice Address - Fax:570-836-7979
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD046666L207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101142264 0001Medicaid
PA121467Medicare UPIN
PA101142264 0001Medicaid