Provider Demographics
NPI:1851991368
Name:MARTIN, LINDAY J
Entity Type:Individual
Prefix:
First Name:LINDAY
Middle Name:J
Last Name:MARTIN
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 1:520 IMEL RD
Mailing Address - Street 2:
Mailing Address - City:NORMALVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15469
Mailing Address - Country:US
Mailing Address - Phone:724-880-7194
Mailing Address - Fax:
Practice Address - Street 1:1450 MORRELL AVE
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425
Practice Address - Country:US
Practice Address - Phone:724-626-4482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP446708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist