Healthcare Provider Details

I. General information

NPI: 1598095747
Provider Name (Legal Business Name): LIN ZHENG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2010
Last Update Date: 11/11/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 PHILADELPHIA PIKE STE A
CLAYMONT DE
19703-2431
US

IV. Provider business mailing address

414 LAUREL CREEK BLVD
MOORESTOWN NJ
08057-3968
US

V. Phone/Fax

Practice location:
  • Phone: 302-317-1531
  • Fax: 302-291-4986
Mailing address:
  • Phone: 302-317-1531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC1-0024131
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: