Provider Demographics
NPI:1356595276
Name:BOOKMAN, LYNDA L
Entity type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:L
Last Name:BOOKMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SMOKEY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-9240
Mailing Address - Country:US
Mailing Address - Phone:315-635-5308
Mailing Address - Fax:
Practice Address - Street 1:111 SMOKEY HOLLOW RD
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-9240
Practice Address - Country:US
Practice Address - Phone:315-635-5308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014529-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics