Provider Demographics
NPI:1225290422
Name:HUERTA SAENZ, LINA PAOLA (MD)
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:PAOLA
Last Name:HUERTA SAENZ
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:PO BOX 858
Mailing Address - Street 2:MCA410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:
Practice Address - Street 1:905 W GOVERNOR RD STE 300
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2307
Practice Address - Country:US
Practice Address - Phone:717-531-4751
Practice Address - Fax:717-531-6139
Is Sole Proprietor?:No
Enumeration Date:2008-06-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110315942080P0205X
KS04-373612080P0205X
PAMT192659390200000X
PAMD4633642080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program