Healthcare Provider Details

I. General information

NPI: 1770901050
Provider Name (Legal Business Name): HUNG YANG LIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PROSPECT AVE RADIOLOGY DEPT
HACKENSACK NJ
07601-1915
US

IV. Provider business mailing address

130 KINDERKAMACK RD STE 200
RIVER EDGE NJ
07661-1951
US

V. Phone/Fax

Practice location:
  • Phone: 201-488-2660
  • Fax:
Mailing address:
  • Phone: 201-488-2660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD61133647
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA12955100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: