Provider Demographics
NPI:1073781621
Name:LIN, DANIEL YANFENG (MD, PHD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:YANFENG
Last Name:LIN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:3353 COTTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-1603
Mailing Address - Country:US
Mailing Address - Phone:215-332-4410
Mailing Address - Fax:215-332-6255
Practice Address - Street 1:3353 COTTMAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-1603
Practice Address - Country:US
Practice Address - Phone:215-332-4410
Practice Address - Fax:215-332-6255
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-18
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD439167208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARES000OtherRESIDENCY PROGRAM