Provider Demographics
NPI:1578680351
Name:PETERS, LINDA K (RN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:K
Last Name:PETERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15 PERRY AVE
Mailing Address - Street 2:UNIT C-5
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-1659
Mailing Address - Country:US
Mailing Address - Phone:203-840-0370
Mailing Address - Fax:
Practice Address - Street 1:3959 BROADWAY
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:212-305-2521
Practice Address - Fax:212-305-6103
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF380321-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics