Provider Demographics
NPI:1639224397
Name:REUTER, LINDA A (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:A
Last Name:REUTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 CLINCH AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2443
Mailing Address - Country:US
Mailing Address - Phone:516-326-4507
Mailing Address - Fax:516-326-4508
Practice Address - Street 1:95 CLINCH AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2443
Practice Address - Country:US
Practice Address - Phone:516-326-4507
Practice Address - Fax:516-326-4508
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007185-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY917310OtherNY STATE EMPIRE PLAN
NY5804221OtherGHI PROVIDER NUMBER
NYCO7185-4BOtherWORKERS COMPENSATION
NYX11121Medicare ID - Type Unspecified
NY917310OtherNY STATE EMPIRE PLAN