Provider Demographics
NPI:1740542117
Name:LINTNER, JESSICA
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:LINTNER
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 1:66-13 52 RD.
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378
Mailing Address - Country:US
Mailing Address - Phone:347-466-6560
Mailing Address - Fax:
Practice Address - Street 1:6613 52ND RD
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-1409
Practice Address - Country:US
Practice Address - Phone:347-466-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1020317501OtherUNITED HEALTH CARE