Provider Demographics
NPI:1467538090
Name:HATCH, LINDA ELLEN (PT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ELLEN
Last Name:HATCH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:ELLEN
Other - Last Name:STURM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:515 MAIN STREET
Mailing Address - Street 2:OLEAN GENERAL HOSPITAL
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760
Mailing Address - Country:US
Mailing Address - Phone:716-375-7481
Mailing Address - Fax:716-375-6410
Practice Address - Street 1:515 MAIN STREET
Practice Address - Street 2:OLEAN GENERAL HOSPITAL
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760
Practice Address - Country:US
Practice Address - Phone:716-375-7481
Practice Address - Fax:716-375-6410
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012544225100000X
PAPT 015099225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01861579Medicaid
NY02201334Medicaid