Provider Demographics
NPI:1275863151
Name:THORNTON, LINDA VARNADORE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:VARNADORE
Last Name:THORNTON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 FORT WASHINGTON AVE APT 1F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-2081
Mailing Address - Country:US
Mailing Address - Phone:212-568-0553
Mailing Address - Fax:
Practice Address - Street 1:506 FORT WASHINGTON AVE APT 1F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-2081
Practice Address - Country:US
Practice Address - Phone:212-568-0553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304354363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health