Provider Demographics
NPI:1396019675
Name:FOBIH, LINDA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:
Last Name:FOBIH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N 6TH ST
Mailing Address - Street 2:PH
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-2914
Mailing Address - Country:US
Mailing Address - Phone:973-687-5556
Mailing Address - Fax:
Practice Address - Street 1:30 N 6TH ST
Practice Address - Street 2:PH
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-2914
Practice Address - Country:US
Practice Address - Phone:973-687-5556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-03
Last Update Date:2012-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309316-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse