Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 235039 | NY |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 235039-1 | NY |
NPI | 1073549341 |
---|---|
Provider Name | Elaine Karen Mobbs Lindgren |
First Address | Kingston, NY 12401-3510 |
Second Address | Kingston, NY 12401-3510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 11/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02640980 | (05) | NY |
02816342 | (05) | NY |
1932304532 | GROUP NPI (01) | NY |
I57938 | (02) | NY |