Provider Demographics
NPI:1053369041
Name:BAILEY, LINDA (PA)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:40 NORWYN RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2018
Mailing Address - Country:US
Mailing Address - Phone:215-456-7000
Mailing Address - Fax:215-254-2599
Practice Address - Street 1:101 E OLNEY AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-2421
Practice Address - Country:US
Practice Address - Phone:215-456-7000
Practice Address - Fax:215-254-2599
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA077566Medicare ID - Type Unspecified