Provider Demographics
NPI:1780215236
Name:PHINAZEE, LINDA JOYCE
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:JOYCE
Last Name:PHINAZEE
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 1:1841 CHOWAN ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-1701
Mailing Address - Country:US
Mailing Address - Phone:646-406-4235
Mailing Address - Fax:
Practice Address - Street 1:1841 CHOWAN ST
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-1701
Practice Address - Country:US
Practice Address - Phone:646-406-4235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304733163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse