Provider Demographics
NPI:1497818033
Name:PREISER, LYNDA L (NP)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:L
Last Name:PREISER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:NY
Mailing Address - Zip Code:13856-1431
Mailing Address - Country:US
Mailing Address - Phone:607-865-5021
Mailing Address - Fax:
Practice Address - Street 1:2 MAIN ST
Practice Address - Street 2:FOREMAN HALL SUNY, DELHI
Practice Address - City:DELHI
Practice Address - State:NY
Practice Address - Zip Code:13753-1144
Practice Address - Country:US
Practice Address - Phone:607-746-4690
Practice Address - Fax:607-746-4141
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY380125363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics