1962713420 NPI number — DR. LINDA MARIE CIMINO NP, EDD

Table of content: DR. LINDA MARIE CIMINO NP, EDD (NPI 1962713420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962713420 NPI number — DR. LINDA MARIE CIMINO NP, EDD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CIMINO
Provider First Name:
LINDA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
NP, EDD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962713420
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SUNY STONY BROOK DEPT OF ANESTHESIOLOGY
Provider Second Line Business Mailing Address:
HSC L 4, RM 060
Provider Business Mailing Address City Name:
STONY BROOK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11794-8480
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-444-2968
Provider Business Mailing Address Fax Number:
631-444-9179

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SUNY STONY BROOK DEPT OF ANESTHESIOLOGY
Provider Second Line Business Practice Location Address:
HSC L 4, RM 060
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8480
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-2968
Provider Business Practice Location Address Fax Number:
631-444-9179
Provider Enumeration Date:
06/29/2010

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: 363LP0200X , with the licence number:  F381265-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: F303322-1 , 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)