Provider Demographics
NPI:1356326193
Name:LINZER, STEVEN P (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:P
Last Name:LINZER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:30 MERRICK AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1580
Mailing Address - Country:US
Mailing Address - Phone:516-539-0301
Mailing Address - Fax:516-280-3519
Practice Address - Street 1:30 MERRICK AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1580
Practice Address - Country:US
Practice Address - Phone:516-539-0301
Practice Address - Fax:516-280-3519
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2012-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY195073207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY16214611Medicaid
NY16214611Medicaid
NY670252Medicare ID - Type Unspecified