Provider Demographics
NPI:1891725404
Name:ROBERTSON, LINDA J (APRN-BC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:J
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 BELLMORE AVE
Mailing Address - Street 2:
Mailing Address - City:N. BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710
Mailing Address - Country:US
Mailing Address - Phone:516-316-2637
Mailing Address - Fax:516-486-2970
Practice Address - Street 1:1918 BELLMORE AVE
Practice Address - Street 2:
Practice Address - City:N. BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710
Practice Address - Country:US
Practice Address - Phone:516-316-2637
Practice Address - Fax:516-486-2970
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400811-0363LP0808X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health