Provider Demographics
NPI:1366897290
Name:VIROSTKO, LINDA (RN, MPH)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:VIROSTKO
Suffix:
Gender:F
Credentials:RN, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 GREEN AVE
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-5007
Mailing Address - Country:US
Mailing Address - Phone:215-588-0587
Mailing Address - Fax:
Practice Address - Street 1:121 GREEN AVE
Practice Address - Street 2:
Practice Address - City:BELLE MEAD
Practice Address - State:NJ
Practice Address - Zip Code:08502-5007
Practice Address - Country:US
Practice Address - Phone:215-588-0587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2019-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN242788L163WC1500X, 2083P0901X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine