Provider Demographics
NPI:1093279358
Name:ASTACIO-HOLDAMPF, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:ASTACIO-HOLDAMPF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WILES DR
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-2412
Mailing Address - Country:US
Mailing Address - Phone:845-825-1498
Mailing Address - Fax:
Practice Address - Street 1:101 STAGE RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3512
Practice Address - Country:US
Practice Address - Phone:845-827-6227
Practice Address - Fax:845-827-6228
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator