Provider Demographics
NPI:1114319993
Name:SHAY, LINDA P (RPN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:P
Last Name:SHAY
Suffix:
Gender:F
Credentials:RPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 SILVER SPUR RD W
Mailing Address - Street 2:
Mailing Address - City:PURLING
Mailing Address - State:NY
Mailing Address - Zip Code:12470-3306
Mailing Address - Country:US
Mailing Address - Phone:845-616-9858
Mailing Address - Fax:
Practice Address - Street 1:307 SILVER SPUR RD W
Practice Address - Street 2:
Practice Address - City:PURLING
Practice Address - State:NY
Practice Address - Zip Code:12470-3306
Practice Address - Country:US
Practice Address - Phone:845-616-9858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254848-1163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice