Healthcare Provider Details

I. General information

NPI: 1063517423
Provider Name (Legal Business Name): J & P LIN MEDICAL ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 RANDOLPH RD SUITE 102
ROCKVILLE MD
20852-2257
US

IV. Provider business mailing address

4701 RANDOLPH RD SUITE 102
ROCKVILLE MD
20852-2257
US

V. Phone/Fax

Practice location:
  • Phone: 301-881-6651
  • Fax: 301-881-6653
Mailing address:
  • Phone: 301-881-6651
  • Fax: 301-881-6653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0058236
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberD0059485
License Number StateMD

VIII. Authorized Official

Name: DR. JENNY ZHANG LIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 301-881-6651