Provider Demographics
NPI:1457616831
Name:ROSS, LINDA (CS)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HIGHBROOK RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-3903
Mailing Address - Country:US
Mailing Address - Phone:203-866-1200
Mailing Address - Fax:
Practice Address - Street 1:17 HIGHBROOK RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-3903
Practice Address - Country:US
Practice Address - Phone:203-866-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner