Provider Demographics
NPI:1851493233
Name:LIN, JOSEPH Y (MD PHD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:Y
Last Name:LIN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 RUSSELL AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877
Mailing Address - Country:US
Mailing Address - Phone:301-590-0722
Mailing Address - Fax:301-590-1154
Practice Address - Street 1:8 RUSSELL AVE
Practice Address - Street 2:STE 101
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877
Practice Address - Country:US
Practice Address - Phone:301-590-0722
Practice Address - Fax:301-590-1154
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD32137208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5392OtherBLUE CROSS BLUE SHIELD MD
DC161355Medicare ID - Type Unspecified
MD161355Medicare ID - Type Unspecified
D09406Medicare UPIN