Provider Demographics
NPI:1235912668
Name:LINDSLEY, HEATHER GRACE
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:GRACE
Last Name:LINDSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 RAILROAD CIR # DN1
Mailing Address - Street 2:
Mailing Address - City:PORT JERVIS
Mailing Address - State:NY
Mailing Address - Zip Code:12771-2917
Mailing Address - Country:US
Mailing Address - Phone:845-281-4320
Mailing Address - Fax:845-672-3969
Practice Address - Street 1:36 RAILROAD CIR # DN1
Practice Address - Street 2:
Practice Address - City:PORT JERVIS
Practice Address - State:NY
Practice Address - Zip Code:12771-2917
Practice Address - Country:US
Practice Address - Phone:845-281-4320
Practice Address - Fax:845-672-3969
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi