Provider Demographics
NPI:1548879109
Name:PARADISO, LINDA ANN (DNP, RN, NPP)
Entity type:Individual
Prefix:DR
First Name:LINDA ANN
Middle Name:
Last Name:PARADISO
Suffix:
Gender:F
Credentials:DNP, RN, NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2133
Mailing Address - Country:US
Mailing Address - Phone:917-710-7730
Mailing Address - Fax:
Practice Address - Street 1:300 JAY ST # A611M
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-1909
Practice Address - Country:US
Practice Address - Phone:718-260-5129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345702163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult