Provider Demographics
NPI:1326316373
Name:LINZER, DAVID (RN)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LINZER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CRAFTON CT
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1615
Mailing Address - Country:US
Mailing Address - Phone:516-924-6168
Mailing Address - Fax:
Practice Address - Street 1:12 CRAFTON CT
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-1615
Practice Address - Country:US
Practice Address - Phone:516-924-6168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY460422163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse