Provider Demographics
NPI:1861089609
Name:LINDER, ASHLEY C
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:C
Last Name:LINDER
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 1:345 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-3016
Mailing Address - Country:US
Mailing Address - Phone:347-533-0946
Mailing Address - Fax:888-975-7704
Practice Address - Street 1:10818 QUEENS BLVD STE 4A5TH
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4748
Practice Address - Country:US
Practice Address - Phone:347-533-0946
Practice Address - Fax:888-975-7704
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY256260OtherEARLY INTERVENTION PROGRAM