Provider Demographics
NPI:1538191424
Name:KIRSCHENBAUM, LINDA A (DO)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:KIRSCHENBAUM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-7200
Mailing Address - Country:US
Mailing Address - Phone:212-604-1824
Mailing Address - Fax:212-604-1892
Practice Address - Street 1:ST. VINCENTS HOSPITAL 153 WEST 11TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-604-8336
Practice Address - Fax:212-604-8061
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184033207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01733453Medicaid
NYCF6456OtherRAILROAD MEDICARE
NYG43452Medicare UPIN
NY26N401Medicare PIN