Provider Demographics
NPI:1790825552
Name:LIN, ELAINA E (MD)
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:E
Last Name:LIN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:100 EAST PENN SQUARE
Mailing Address - Street 2:THE WANAMAKER BUILDING, 9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9300
Mailing Address - Fax:267-425-9331
Practice Address - Street 1:34TH STREET AND CIVIC CENTER BLVD
Practice Address - Street 2:SUITE 9329
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4399
Practice Address - Country:US
Practice Address - Phone:215-590-1858
Practice Address - Fax:215-590-1415
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2013-04-10
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Provider Licenses
StateLicense IDTaxonomies
PAMD439603207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA227069EJLOtherMEDICARE PTAN
PA1026289190001Medicaid