Provider Demographics
NPI:1790184711
Name:ZIERES, LINDA J (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:ZIERES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WOODLAND POND CIR
Mailing Address - Street 2:APT 327
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-6405
Mailing Address - Country:US
Mailing Address - Phone:845-256-5532
Mailing Address - Fax:
Practice Address - Street 1:100 WOODLAND POND CIR
Practice Address - Street 2:APT 327
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-6405
Practice Address - Country:US
Practice Address - Phone:845-256-5532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006233-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical