Provider Demographics
NPI:1326014010
Name:LINCOLN, LINDA J (DC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BIG FLATS
Mailing Address - State:NY
Mailing Address - Zip Code:14814
Mailing Address - Country:US
Mailing Address - Phone:607-562-7601
Mailing Address - Fax:607-562-7601
Practice Address - Street 1:142 MAIN ST
Practice Address - Street 2:
Practice Address - City:BIG FLATS
Practice Address - State:NY
Practice Address - Zip Code:14814
Practice Address - Country:US
Practice Address - Phone:607-562-7601
Practice Address - Fax:607-562-7601
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007812111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U53374Medicare UPIN
NY56260BMedicare ID - Type Unspecified