Provider Demographics
NPI:1659361616
Name:LIN, JENNY ZHANG (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:ZHANG
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4701 RANDOLPH RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2257
Mailing Address - Country:US
Mailing Address - Phone:310-881-6651
Mailing Address - Fax:301-881-6653
Practice Address - Street 1:4701 RANDOLPH RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2257
Practice Address - Country:US
Practice Address - Phone:310-881-6651
Practice Address - Fax:301-881-6653
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00594852084N0400X, 2084N0600X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD194195OtherAMERIGROUP MEDICAID
MD0501922OtherUNITED HEALTH
MDK143-0001OtherBC/BS DC AND FEDERAL
MD4100334OtherMAMSI
MD620189-01OtherBC/BS MARYLAND
MD669114OtherNCPPO
MD2747888OtherCIGNA
MD101802OtherJOHNS HOPKINS HEALTH CARE
MD3640877OtherAETNA HMO
MD403868100Medicaid
MD2278423OtherCCN
MD7691425OtherAETNA-PPO
MD4100334OtherMAMSI
MD620189-01OtherBC/BS MARYLAND