Basic Information
| Provider Information | |||||||||
| NPI: | 1063546331 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZINTL | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | |||||||||
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| Credential: | R.N., CDE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5945 161ST ST | ||||||||
| Address2: | |||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113651414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187623111 | ||||||||
| FaxNumber: | 7183536315 | ||||||||
| Practice Location | |||||||||
| Address1: | 5945 161ST ST | ||||||||
| Address2: | |||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113651414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187623111 | ||||||||
| FaxNumber: | 7183536315 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WD0400X | 288484-1 | NY | Y | Nursing Service Providers | Registered Nurse | Diabetes Educator |
ID Information
| ID | Type | State | Issuer | Description | 288484-1 | 01 | NY | LICENSE | OTHER |