Provider Demographics
NPI:1295895860
Name:HU, LIN (DDS,PHD)
Entity type:Individual
Prefix:
First Name:LIN
Middle Name:
Last Name:HU
Suffix:
Gender:M
Credentials:DDS,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 HYNES AVE
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-5034
Mailing Address - Country:US
Mailing Address - Phone:718-920-6266
Mailing Address - Fax:718-515-5419
Practice Address - Street 1:MMC - DEPT. OF DENTISTRY
Practice Address - Street 2:3332 ROCHAMBEAU AVENUE, 2ND FL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-6266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048932122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist