Provider Demographics
NPI:1033123161
Name:LIN, JUDY MEI-CHIA (MD)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:MEI-CHIA
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 TEANECK RD STE 4C
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4855
Mailing Address - Country:US
Mailing Address - Phone:201-837-9449
Mailing Address - Fax:201-578-1699
Practice Address - Street 1:1086 TEANECK RD STE 4C
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4855
Practice Address - Country:US
Practice Address - Phone:201-837-9449
Practice Address - Fax:201-578-1699
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA069382207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ168175Medicare UPIN
107052R7WMedicare ID - Type Unspecified