Provider Demographics
NPI:1881795920
Name:ANGUS, LYNDA MESSINA (PT)
Entity type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:MESSINA
Last Name:ANGUS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LYNDA
Other - Middle Name:
Other - Last Name:MESSINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2 EXECUTIVE BLVD
Mailing Address - Street 2:OFC 204A
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-8218
Mailing Address - Country:US
Mailing Address - Phone:201-236-5066
Mailing Address - Fax:845-357-3897
Practice Address - Street 1:2 EXECUTIVE BLVD
Practice Address - Street 2:SUITE 204A
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4164
Practice Address - Country:US
Practice Address - Phone:845-357-5686
Practice Address - Fax:845-357-3897
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA05414225100000X
NY023817225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQN4621Medicare PIN
NJ088671Medicare PIN