Healthcare Provider Details

I. General information

NPI: 1265716864
Provider Name (Legal Business Name): MR. DONG L LIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2011
Last Update Date: 10/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1147 SOUTH AVE
PLAINFIELD NJ
07062-1934
US

IV. Provider business mailing address

37 MANOR DR
MARLBORO NJ
07746-1972
US

V. Phone/Fax

Practice location:
  • Phone: 908-757-7703
  • Fax: 908-757-2084
Mailing address:
  • Phone: 732-306-8881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI0275353500
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: