Basic Information
| Provider Information | |||||||||
| NPI: | 1538690847 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAO | ||||||||
| FirstName: | LINDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | ONE MEDICAL CENTER DR | ||||||||
| Address2: | DHMC DEPARTMENT OF PSYCHIATRY | ||||||||
| City: | LEBANON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 037560001 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | ONE MEDICAL CENTER DR | ||||||||
| Address2: | DHMC DEPARTMENT OF PSYCHIATRY | ||||||||
| City: | LEBANON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 037560001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036507075 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2017 | ||||||||
| LastUpdateDate: | 06/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 63868 | NY | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.