Provider Demographics
NPI:1669613477
Name:MCGILL, LINDA ANNE (PA-C)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ANNE
Last Name:MCGILL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CAMDEN ROAD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844
Mailing Address - Country:US
Mailing Address - Phone:908-874-0673
Mailing Address - Fax:908-707-0816
Practice Address - Street 1:71 ROUTE 206
Practice Address - Street 2:YOUR DOCTORS CARE
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844
Practice Address - Country:US
Practice Address - Phone:908-685-1887
Practice Address - Fax:908-707-0816
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00004500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
S52159Medicare UPIN