Provider Demographics
NPI:1801040050
Name:TODD B. LINDEN MD PC
Entity Type:Organization
Organization Name:TODD B. LINDEN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:B
Authorized Official - Last Name:LINDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:212-219-3210
Mailing Address - Street 1:594 BROADWAY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3234
Mailing Address - Country:US
Mailing Address - Phone:212-219-3210
Mailing Address - Fax:212-966-5099
Practice Address - Street 1:594 BROADWAY
Practice Address - Street 2:SUITE 310
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3234
Practice Address - Country:US
Practice Address - Phone:212-219-3210
Practice Address - Fax:212-966-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197119174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01765402Medicaid
NYA100001506Medicare PIN
NYA400012459Medicare PIN