Basic Information
Provider Information
NPI: 1003139973
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAI-HUYNH
FirstName: LINDA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 90-31 53RD AVE
Address2:  
City: ELMHURST
State: NY
PostalCode: 11373
CountryCode: US
TelephoneNumber: 7183933983
FaxNumber:  
Practice Location
Address1: 1500 LEXINGTON AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100297349
CountryCode: US
TelephoneNumber: 2122893846
FaxNumber: 2122893550
Other Information
ProviderEnumerationDate: 03/08/2010
LastUpdateDate: 03/08/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X045286NYY Pharmacy Service ProvidersPharmacist 

No ID Information.


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