Provider Demographics
NPI:1639383920
Name:TUTUNJIAN, LINDA MARY
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARY
Last Name:TUTUNJIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 MAPLE AVE
Mailing Address - Street 2:APT. 10A
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4255
Mailing Address - Country:US
Mailing Address - Phone:516-678-3482
Mailing Address - Fax:
Practice Address - Street 1:9502 ROCKAWAY BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:NY
Practice Address - Zip Code:11693-1317
Practice Address - Country:US
Practice Address - Phone:718-474-2478
Practice Address - Fax:718-474-2165
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health