Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | F000578 | NY |
NPI | 1073624532 |
---|---|
Provider Name | Linda Mandl Stocker |
First Address | Philadelphia, PA 19170-0001 |
Second Address | Carmel, NY 10512-3940 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 06/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01462835 | (05) | NY |