Provider Demographics
NPI:1326279753
Name:LIN, KUNG-CHING
Entity Type:Individual
Prefix:
First Name:KUNG-CHING
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 UNION ST STE 3L
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5670
Mailing Address - Country:US
Mailing Address - Phone:718-939-5213
Mailing Address - Fax:
Practice Address - Street 1:3808 UNION ST STE 3L
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5670
Practice Address - Country:US
Practice Address - Phone:718-939-5213
Practice Address - Fax:718-939-8949
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259906-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine