Provider Demographics
NPI:1134202914
Name:GILL, LINDA M (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:GILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVENUE
Mailing Address - Street 2:BOX PSYCH
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-8409
Mailing Address - Country:US
Mailing Address - Phone:585-275-6733
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVENUE
Practice Address - Street 2:BOX PSYCH
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-8409
Practice Address - Country:US
Practice Address - Phone:585-275-6733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229057-1207R00000X, 2084P0800X
NY2290572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH91556Medicare UPIN