Provider Demographics
NPI:1851314751
Name:DAHL, LINDA D (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:D
Last Name:DAHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E 56TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3607
Mailing Address - Country:US
Mailing Address - Phone:212-920-3047
Mailing Address - Fax:646-964-9693
Practice Address - Street 1:120 E 56TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3607
Practice Address - Country:US
Practice Address - Phone:212-920-3047
Practice Address - Fax:646-964-9693
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228037174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3412590OtherAETNA PROVIDER ID
NY4C9116OtherHEALTHNET PROVIDER ID
NY9623860OtherCIGNA PROVIDER ID
NY9623860OtherELDERPLAN PROVIDER ID
NY77384OtherGHI PROVIDER ID
NYP2968890OtherOXFORD PROVIDER ID
NY129354POtherHIP PROVIDER ID
NY9623860OtherELDERPLAN PROVIDER ID
NY9623860OtherCIGNA PROVIDER ID