Provider Demographics
NPI:1881806297
Name:ZHAO, LINA (LAC, OMD)
Entity type:Individual
Prefix:DR
First Name:LINA
Middle Name:
Last Name:ZHAO
Suffix:
Gender:F
Credentials:LAC, OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1264 LEXINGTON AVE
Mailing Address - Street 2:2N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2064
Mailing Address - Country:US
Mailing Address - Phone:212-996-2988
Mailing Address - Fax:212-541-7339
Practice Address - Street 1:1264 LEXINGTON AVE
Practice Address - Street 2:2N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2064
Practice Address - Country:US
Practice Address - Phone:212-996-2988
Practice Address - Fax:212-541-7339
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002595171100000X
CAAC6831171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist