Provider Demographics
NPI:1467488460
Name:LINDEN, TODD B (MD PC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:B
Last Name:LINDEN
Suffix:
Gender:M
Credentials:MD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:594 BROADWAY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3234
Mailing Address - Country:US
Mailing Address - Phone:212-219-3210
Mailing Address - Fax:212-966-5099
Practice Address - Street 1:594 BROADWAY
Practice Address - Street 2:SUITE 310
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3234
Practice Address - Country:US
Practice Address - Phone:212-219-3210
Practice Address - Fax:212-966-5099
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197119174400000X, 207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01764502Medicaid
NYA100001506Medicare PIN
NYA400012459Medicare PIN