Provider Demographics
NPI:1740447812
Name:GOLD, LINDA ANN (PTA)
Entity type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:ANN
Last Name:GOLD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 S DUFFY RD
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-2422
Mailing Address - Country:US
Mailing Address - Phone:724-355-8282
Mailing Address - Fax:
Practice Address - Street 1:9399 BABCOCK BLVD
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-2008
Practice Address - Country:US
Practice Address - Phone:412-366-8540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE005072L225200000X
PATEI000664225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant