Provider Demographics
NPI:1750443784
Name:FISCHER, LINDA L (MS, PTA, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MS, PTA, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 KING RD
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3409
Mailing Address - Country:US
Mailing Address - Phone:203-272-9778
Mailing Address - Fax:
Practice Address - Street 1:636 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-4408
Practice Address - Country:US
Practice Address - Phone:203-934-6690
Practice Address - Fax:203-934-6659
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000181225200000X
CT0001752255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000175OtherATC LICENSE
CT000181OtherPHYSICAL THERAPY ASSIST