Provider Demographics
NPI:1922318658
Name:LIN, LI (DPT)
Entity Type:Individual
Prefix:
First Name:LI
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 WALL STREET
Mailing Address - Street 2:MAIN FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005
Mailing Address - Country:US
Mailing Address - Phone:212-587-8606
Mailing Address - Fax:212-587-9024
Practice Address - Street 1:14 WALL STREET
Practice Address - Street 2:MAIN FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005
Practice Address - Country:US
Practice Address - Phone:212-587-8606
Practice Address - Fax:212-587-9024
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033162-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist