Provider Demographics
NPI:1336228162
Name:WEEMS, LINDA (RDH)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:WEEMS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ELGAR PL
Mailing Address - Street 2:APARTMENT #32D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-5002
Mailing Address - Country:US
Mailing Address - Phone:718-379-7665
Mailing Address - Fax:212-986-9635
Practice Address - Street 1:150 E 45TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-3115
Practice Address - Country:US
Practice Address - Phone:212-949-4900
Practice Address - Fax:212-986-9635
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015705124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist