Provider Demographics
NPI:1669207502
Name:LIN, MENG CHIEH (DPT)
Entity type:Individual
Prefix:
First Name:MENG CHIEH
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4703 213TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3327
Mailing Address - Country:US
Mailing Address - Phone:917-833-7908
Mailing Address - Fax:
Practice Address - Street 1:7119 80TH ST STE 8210
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7733
Practice Address - Country:US
Practice Address - Phone:718-554-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053026225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist