Provider Demographics
NPI:1073766648
Name:TUN LIN MD., PC
Entity Type:Organization
Organization Name:TUN LIN MD., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TUN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-592-4900
Mailing Address - Street 1:5023 229TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-1515
Mailing Address - Country:US
Mailing Address - Phone:718-423-0184
Mailing Address - Fax:
Practice Address - Street 1:9024 CORONA AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4047
Practice Address - Country:US
Practice Address - Phone:718-592-4900
Practice Address - Fax:718-592-3863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202102261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01707437Medicaid
NY03147OtherGHI MEDICARE
NY943923OtherEMPIRE MEDICARE
NY01707437Medicaid