Provider Demographics
NPI:1275979551
Name:LIN, YOLIE (PT)
Entity Type:Individual
Prefix:MR
First Name:YOLIE
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8337 SAINT JAMES AVE
Mailing Address - Street 2:2-H
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3707
Mailing Address - Country:US
Mailing Address - Phone:718-728-1809
Mailing Address - Fax:
Practice Address - Street 1:4233 KISSENA BLVD
Practice Address - Street 2:#1A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3241
Practice Address - Country:US
Practice Address - Phone:718-888-7122
Practice Address - Fax:718-939-6200
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010822-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist