Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 157966 | NY |
NPI | 1073551537 |
---|---|
Provider Name | Dr. Linda Anne Shookster |
First Address | Plainview, NY 11803-6502 |
Second Address | Bronx, NY 10458-5049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 30/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01189495 | (05) | NY |
157966 | LICENSE (01) | NY |
E44687 | (02) |