Provider Demographics
NPI:1942207600
Name:LIN, JUDY CHIN YU (MD)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:CHIN YU
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 AMANDA CT
Mailing Address - Street 2:
Mailing Address - City:AIRMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10952-4104
Mailing Address - Country:US
Mailing Address - Phone:845-504-0550
Mailing Address - Fax:
Practice Address - Street 1:6 AMANDA CT
Practice Address - Street 2:
Practice Address - City:AIRMONT
Practice Address - State:NY
Practice Address - Zip Code:10952-4104
Practice Address - Country:US
Practice Address - Phone:845-504-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07921900207R00000X
NY235858207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0286877SMedicaid
I39548Medicare UPIN
NJ094014Medicare PIN