Healthcare Provider Details

I. General information

NPI: 1124092085
Provider Name (Legal Business Name): HENRY LIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

294 PLEASANT ST STE 105
STOUGHTON MA
02072-2571
US

IV. Provider business mailing address

20 ROCHE BROTHERS WAY STE 6 #332
NORTH EASTON MA
02356-1030
US

V. Phone/Fax

Practice location:
  • Phone: 774-227-8482
  • Fax: 510-369-3816
Mailing address:
  • Phone: 774-227-8482
  • Fax: 510-369-3816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number237242
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2086P0122X
TaxonomyPhysician Nutrition Specialist (Surgery)
License Number237242
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: