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NPI Code Detail

MEDICARE: CHARLES Y JIN MD

MEDICARE: CHARLES Y JIN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician222414NY

General Provider Information

NPI Number : 1801966924
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES Y JIN MD
Provider Business Mailing Address
First Line : 400 COMMUNITY DR
Second Line :
City : MANHASSET
State : NY
Zip : 11030-3815
Country : US
Telephone Number : 718-920-7460
Fax Number : 718-515-5403
Provider Business Practice Location Address
First Line : MMC - PSYC. OBSERVATION SERV.
Second Line : 111 E. 210TH STREET
City : BRONX
State : NY
Zip : 10467
Country : US
Telephone Number : 718-920-7460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 07/08/2007

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