Provider Demographics
NPI:1245782663
Name:LIN, YOU Q (PA, RDN, CDN)
Entity type:Individual
Prefix:
First Name:YOU
Middle Name:Q
Last Name:LIN
Suffix:
Gender:F
Credentials:PA, RDN, CDN
Other - Prefix:MISS
Other - First Name:NEVAEH
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:310 E 70TH ST APT 11V
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-8621
Mailing Address - Country:US
Mailing Address - Phone:646-421-4716
Mailing Address - Fax:
Practice Address - Street 1:310 E 70TH ST APT 11V
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-8621
Practice Address - Country:US
Practice Address - Phone:646-421-4716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032657363AM0700X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical