1508153354 NPI number — MS. LINDA B FEYDER LMSW

Table of content: MS. LINDA B FEYDER LMSW (NPI 1508153354)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508153354 NPI number — MS. LINDA B FEYDER LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FEYDER
Provider First Name:
LINDA
Provider Middle Name:
B
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FEYDER
Provider Other First Name:
LINDA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1508153354
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/05/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 N STATION PLZ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREAT NECK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11021-5013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-466-2509
Provider Business Mailing Address Fax Number:
516-482-3146

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21 N STATION PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREAT NECK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11021-5013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-466-2509
Provider Business Practice Location Address Fax Number:
516-482-3146
Provider Enumeration Date:
06/30/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  076186-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)