Provider Demographics
NPI:1831153360
Name:PARLIN, LINDA S
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:PARLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1561 LONG POND RD
Mailing Address - Street 2:STE 210
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626
Mailing Address - Country:US
Mailing Address - Phone:585-454-3190
Mailing Address - Fax:585-454-7328
Practice Address - Street 1:1561 LONG POND RD
Practice Address - Street 2:STE 210
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626
Practice Address - Country:US
Practice Address - Phone:585-454-3190
Practice Address - Fax:585-454-7328
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150153208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00947273Medicaid
NYMD4438OtherPREF CARE
NY00947273Medicaid
NYMD4438OtherPREF CARE