Provider Demographics
NPI:1598854697
Name:LINNELL-BECKER, DIANE J (DO)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:J
Last Name:LINNELL-BECKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 217
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1404
Mailing Address - Country:US
Mailing Address - Phone:516-222-8181
Mailing Address - Fax:516-222-8165
Practice Address - Street 1:2900 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 217
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1401
Practice Address - Country:US
Practice Address - Phone:516-222-8181
Practice Address - Fax:516-222-8165
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183746-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1216V1OtherEMPIRE BCBS PPO EPO
NYF30526Medicare UPIN
NY60C401Medicare ID - Type Unspecified