Provider Demographics
NPI:1861004657
Name:LIN, PAO-CHEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:PAO-CHEN
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9408 66TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4632
Mailing Address - Country:US
Mailing Address - Phone:937-580-7617
Mailing Address - Fax:
Practice Address - Street 1:9408 66TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4632
Practice Address - Country:US
Practice Address - Phone:937-580-7617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045927225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist