Provider Demographics
NPI:1780679845
Name:LINZER, DIANE (DO)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:
Last Name:LINZER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 HICKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3415
Mailing Address - Country:US
Mailing Address - Phone:516-937-5000
Mailing Address - Fax:516-931-2535
Practice Address - Street 1:530 HICKSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-3415
Practice Address - Country:US
Practice Address - Phone:516-937-5000
Practice Address - Fax:516-931-2535
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220032207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine