Provider Demographics
NPI:1124564646
Name:LEMNOTIS, LINDA B
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:B
Last Name:LEMNOTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:B
Other - Last Name:LEMNOTIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:228 WEST ST
Mailing Address - Street 2:
Mailing Address - City:PLANTSVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06479-1145
Mailing Address - Country:US
Mailing Address - Phone:860-224-9021
Mailing Address - Fax:
Practice Address - Street 1:228 WEST ST
Practice Address - Street 2:
Practice Address - City:PLANTSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06479-1145
Practice Address - Country:US
Practice Address - Phone:860-224-9021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-08
Last Update Date:2017-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8582172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker