Provider Demographics
NPI:1013550805
Name:GINNY LIN OD PLLC
Entity Type:Organization
Organization Name:GINNY LIN OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GINNY
Authorized Official - Middle Name:XIANGNING
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-229-6780
Mailing Address - Street 1:24812 NORTHERN BLVD STE 1D
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1207
Mailing Address - Country:US
Mailing Address - Phone:718-229-6780
Mailing Address - Fax:718-229-1771
Practice Address - Street 1:24812 NORTHERN BLVD STE 1D
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1207
Practice Address - Country:US
Practice Address - Phone:718-229-6780
Practice Address - Fax:718-229-1771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty