Provider Demographics
NPI:1669174991
Name:HAN, MAI LIN
Entity type:Individual
Prefix:
First Name:MAI
Middle Name:LIN
Last Name:HAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3238
Mailing Address - Country:US
Mailing Address - Phone:631-351-7112
Mailing Address - Fax:631-351-0862
Practice Address - Street 1:2075 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3238
Practice Address - Country:US
Practice Address - Phone:631-351-7112
Practice Address - Fax:631-351-0862
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor