Provider Demographics
NPI:1427184597
Name:LIN, FOONG-YI (MD)
Entity Type:Individual
Prefix:DR
First Name:FOONG-YI
Middle Name:
Last Name:LIN
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 1:1527 RT 12
Mailing Address - Street 2:BOX 608
Mailing Address - City:GALES FERRY
Mailing Address - State:CT
Mailing Address - Zip Code:06335-0608
Mailing Address - Country:US
Mailing Address - Phone:860-464-7248
Mailing Address - Fax:860-464-0125
Practice Address - Street 1:1527 RT 12
Practice Address - Street 2:BOX 608
Practice Address - City:GALES FERRY
Practice Address - State:CT
Practice Address - Zip Code:06335-0608
Practice Address - Country:US
Practice Address - Phone:860-464-7248
Practice Address - Fax:860-464-0125
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD09477208000000X
CT045228208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008035430Medicaid