Provider Demographics
NPI:1841534385
Name:LIN, KAREN XIXUAN (LAC, MSC,)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:XIXUAN
Last Name:LIN
Suffix:
Gender:F
Credentials:LAC, MSC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 GREENWICH RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2237
Mailing Address - Country:US
Mailing Address - Phone:732-494-6218
Mailing Address - Fax:
Practice Address - Street 1:45 SOUTH AVE W STE 201
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2686
Practice Address - Country:US
Practice Address - Phone:908-272-8288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00093600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist