Provider Demographics
NPI:1598953606
Name:LINDA DAHL, MD, PC
Entity Type:Organization
Organization Name:LINDA DAHL, MD, PC
Other - Org Name:DAHL OTOLARYNGOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:DAHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-920-3047
Mailing Address - Street 1:PO BOX 1295
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0039
Mailing Address - Country:US
Mailing Address - Phone:212-920-3047
Mailing Address - Fax:646-964-9693
Practice Address - Street 1:186 E 76TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2844
Practice Address - Country:US
Practice Address - Phone:212-920-3047
Practice Address - Fax:646-964-9693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228037174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
7M2841Medicare PIN
I00140Medicare UPIN