Provider Demographics
NPI:1205451622
Name:SCIBILIA, LINDA RENEE (LPN)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:RENEE
Last Name:SCIBILIA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1226
Mailing Address - Country:US
Mailing Address - Phone:716-201-8337
Mailing Address - Fax:
Practice Address - Street 1:1604 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1226
Practice Address - Country:US
Practice Address - Phone:716-201-8337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280760164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty