Provider Demographics
NPI:1144744640
Name:ANDREI, LINDA WEISENT (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:WEISENT
Last Name:ANDREI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 TAUGHANNOCK BLVD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-9571
Mailing Address - Country:US
Mailing Address - Phone:607-227-8171
Mailing Address - Fax:
Practice Address - Street 1:955 TAUGHANNOCK BLVD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-9571
Practice Address - Country:US
Practice Address - Phone:607-227-8171
Practice Address - Fax:607-227-8171
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-27
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160749207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease