Provider Demographics
NPI:1801895271
Name:TOSETTO, LINDA S (PA)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:TOSETTO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:WEISENBORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:61 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2918
Mailing Address - Country:US
Mailing Address - Phone:716-565-1234
Mailing Address - Fax:716-565-1246
Practice Address - Street 1:61 MAPLE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-2918
Practice Address - Country:US
Practice Address - Phone:716-565-1234
Practice Address - Fax:716-565-1246
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010096-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02626144Medicaid
NYJ400534984OtherMEDICARE
NY1801895271OtherINDEPENDENT HEALTH
NY000570503006OtherHEALTHNOW
NY000570503003OtherHEALTH NOW