Doctor Name: | MS. LINDA ZORAIDA GENSAW |
NPI Number: | 1194167833 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NONE |
License Number: | 1830-23-8598 |
Business Practice Address: | 12406 Cedar Lake Rd Crown Point, IN - 463078736 |
Business Phone Number: | 7738188060 |
Business Fax Number: | |
Mailing Address: | 12406 Cedar Lake Rd, CROWN POINT |
State: | IN |
Postal Code: | 463078736 |
Phone Number: | 7738188060 |
Fax Number: | |
NPI Enumeration Date: | 07/23/2013 |
NPI Last Update Date: | 07/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 347C00000X |
License Number: | 1830-23-8598 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Private Vehicle |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |