Provider Demographics
NPI:1649613050
Name:LINDIAKOS, CATHERINE ANDREA
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANDREA
Last Name:LINDIAKOS
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 1:34 SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6133
Mailing Address - Country:US
Mailing Address - Phone:631-813-0062
Mailing Address - Fax:
Practice Address - Street 1:34 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6133
Practice Address - Country:US
Practice Address - Phone:631-813-0062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY617146121174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist