Provider Demographics
NPI:1740751031
Name:LIN, JIAFENG (PHARMD)
Entity Type:Individual
Prefix:
First Name:JIAFENG
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9845 57TH AVE APT 5L
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-3659
Mailing Address - Country:US
Mailing Address - Phone:646-359-1583
Mailing Address - Fax:
Practice Address - Street 1:7960 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2931
Practice Address - Country:US
Practice Address - Phone:646-359-1583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064403183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist