Provider Demographics
NPI:1407117435
Name:FONTE, LYNDA MARIE
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:MARIE
Last Name:FONTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 SAW MILL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2734
Mailing Address - Country:US
Mailing Address - Phone:914-218-0600
Mailing Address - Fax:
Practice Address - Street 1:2213 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-6301
Practice Address - Country:US
Practice Address - Phone:718-683-3775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY580782111174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist