Provider Demographics
NPI:1386671071
Name:XU, LIN (MD)
Entity Type:Individual
Prefix:
First Name:LIN
Middle Name:
Last Name:XU
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 1:1 BETHANY RD
Mailing Address - Street 2:SUITE 35
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1663
Mailing Address - Country:US
Mailing Address - Phone:732-888-1203
Mailing Address - Fax:732-888-1204
Practice Address - Street 1:1 BETHANY RD
Practice Address - Street 2:SUITE 35
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1663
Practice Address - Country:US
Practice Address - Phone:732-888-1203
Practice Address - Fax:732-888-1204
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA071279207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP2870156OtherOXFORD HEALTH PLAN
NJ7070477OtherAETNA
NJ044867R0EMedicare PIN
NJP2870156OtherOXFORD HEALTH PLAN