Provider Demographics
NPI:1902214117
Name:LIN, SHI-FENG (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:SHI-FENG
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 1:1915 CENTRAL PARK AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2949
Mailing Address - Country:US
Mailing Address - Phone:917-300-9846
Mailing Address - Fax:646-838-3994
Practice Address - Street 1:1915 CENTRAL PARK AVE STE 205
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-2949
Practice Address - Country:US
Practice Address - Phone:917-300-9846
Practice Address - Fax:646-838-3994
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01833800225100000X
NY038631-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist