Provider Demographics
NPI:1164900064
Name:LINDER, JACQUELINE (CNM)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:LINDER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 CORNWELL AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1533
Mailing Address - Country:US
Mailing Address - Phone:862-432-5590
Mailing Address - Fax:
Practice Address - Street 1:300 GARDEN CITY PLZ STE 136
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3329
Practice Address - Country:US
Practice Address - Phone:516-747-9232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife