Provider Demographics
NPI:1497388177
Name:PISANO, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:PISANO
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 1:83 ABBEYVILLE LN
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-1742
Mailing Address - Country:US
Mailing Address - Phone:914-629-6862
Mailing Address - Fax:
Practice Address - Street 1:6800 JERICHO TURNPIKE SUITE 120W
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4445
Practice Address - Country:US
Practice Address - Phone:631-600-3027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant