Provider Demographics
NPI:1891880498
Name:LARSEN, LINDA LESLIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LESLIE
Last Name:LARSEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5000
Mailing Address - Street 2:
Mailing Address - City:CASTLE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:12511-5000
Mailing Address - Country:US
Mailing Address - Phone:845-831-2000
Mailing Address - Fax:845-838-5189
Practice Address - Street 1:VA HUDSON VALLEY HEALTH CARE SYSTEM
Practice Address - Street 2:RT 9D
Practice Address - City:CASTLE POINT
Practice Address - State:NY
Practice Address - Zip Code:12511-5000
Practice Address - Country:US
Practice Address - Phone:845-831-2000
Practice Address - Fax:845-838-5189
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY37056183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY37056OtherPHARMACIST