Provider Demographics
NPI:1457380305
Name:DINOVITZEDELBLUM, LINDA BARBARA (RPH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:BARBARA
Last Name:DINOVITZEDELBLUM
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 1:5505 ROSWELL RD NE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1985
Mailing Address - Country:US
Mailing Address - Phone:718-360-1683
Mailing Address - Fax:
Practice Address - Street 1:5505 ROSWELL RD NE
Practice Address - Street 2:SUITE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1985
Practice Address - Country:US
Practice Address - Phone:718-360-1683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA028008L183500000X
VA0202005855183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist