Provider Demographics
NPI:1609208909
Name:JIN, ERIN J (PT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:J
Last Name:JIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 150TH ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-3887
Mailing Address - Country:US
Mailing Address - Phone:631-871-5886
Mailing Address - Fax:718-746-4920
Practice Address - Street 1:3525 150TH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3887
Practice Address - Country:US
Practice Address - Phone:631-871-5886
Practice Address - Fax:718-746-4920
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036260225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist