Provider Demographics
NPI:1871225060
Name:LIN, ANNIE (CFY-SLP)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-1404
Mailing Address - Country:US
Mailing Address - Phone:646-321-8758
Mailing Address - Fax:
Practice Address - Street 1:997 STAFFORD AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2109
Practice Address - Country:US
Practice Address - Phone:718-948-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist