Provider Demographics
NPI:1467481077
Name:LIN, JULIE T (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:T
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:120 EAGLE ROCK AVE
Mailing Address - Street 2:SUITE 154
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3158
Mailing Address - Country:US
Mailing Address - Phone:201-447-4772
Mailing Address - Fax:
Practice Address - Street 1:120 EAGLE ROCK AVE
Practice Address - Street 2:SUITE 154
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-3158
Practice Address - Country:US
Practice Address - Phone:201-447-4772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223762208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0500J1Medicare UPIN
NYH87723Medicare UPIN