Provider Demographics
NPI:1609266006
Name:LIN, CHUNG-YING (SLP)
Entity Type:Individual
Prefix:MS
First Name:CHUNG-YING
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:165 CHRISTOPHER ST APT 6Z
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2843
Mailing Address - Country:US
Mailing Address - Phone:646-915-5980
Mailing Address - Fax:
Practice Address - Street 1:165 CHRISTOPHER ST APT 6Z
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2843
Practice Address - Country:US
Practice Address - Phone:646-915-5980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025773235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY39Medicaid