Provider Demographics
NPI:1821170242
Name:LIN, EN-SU (MD)
Entity Type:Individual
Prefix:
First Name:EN-SU
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST
Mailing Address - Street 2:STE SW200
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER ANESTHESIA ASSOCIATES
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2919
Practice Address - Fax:856-968-8239
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA043987207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0942075OtherCIGNA
NJ0396918000OtherAMERIHEALTH/KEYSTONE/IBC
NJ2565966OtherUNITED HEALTH
NJ575254OtherAMERIHEALTH PPO/PA BS
NJ60017291OtherHORIZON NJ HEALTH
NJ3754618OtherAETNA
NJ42322OtherUNIVERSITY HEALTH PLAN
NJ3754631OtherAETNA
NJP3722591OtherOXFORD
NJ010007170OtherAMERICHOICE
NJ3590801Medicaid
NJ3590801Medicaid
NJ42322OtherUNIVERSITY HEALTH PLAN
NJP3722591OtherOXFORD