Provider Demographics
NPI:1134103104
Name:BAILEY, LINDA M (PT AL)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:M
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PT AL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 FOULK RD
Mailing Address - Street 2:STE B
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810
Mailing Address - Country:US
Mailing Address - Phone:302-376-7670
Mailing Address - Fax:
Practice Address - Street 1:1600 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801
Practice Address - Country:US
Practice Address - Phone:302-656-5226
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ20000042225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE00000041626Medicaid
DE084500Medicare ID - Type Unspecified