Provider Demographics
NPI:1316022965
Name:LIOTTI, LINDA R (DO)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:R
Last Name:LIOTTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:125 SAND RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-1571
Mailing Address - Country:US
Mailing Address - Phone:973-808-9242
Mailing Address - Fax:973-244-0585
Practice Address - Street 1:125 SAND RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-1571
Practice Address - Country:US
Practice Address - Phone:973-808-9242
Practice Address - Fax:973-244-0585
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB50539207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine