Provider Demographics
NPI:1194087684
Name:BEISS, LINDA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:BEISS
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 1:10 REDTWIG CT
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-4126
Mailing Address - Country:US
Mailing Address - Phone:914-293-0564
Mailing Address - Fax:
Practice Address - Street 1:10 REDTWIG CT
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-4126
Practice Address - Country:US
Practice Address - Phone:914-293-0564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist