Provider Demographics
NPI:1710047360
Name:LINDA LOW, INC
Entity Type:Organization
Organization Name:LINDA LOW, INC
Other - Org Name:DR. LINDA LOW
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-598-5017
Mailing Address - Street 1:221 BROADWAY
Mailing Address - Street 2:SUITE 303
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2780
Mailing Address - Country:US
Mailing Address - Phone:631-598-5017
Mailing Address - Fax:631-789-8571
Practice Address - Street 1:221 BROADWAY
Practice Address - Street 2:SUITE 303
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2780
Practice Address - Country:US
Practice Address - Phone:631-598-5017
Practice Address - Fax:631-789-8571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1677912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01809512Medicaid
NY01809512Medicaid