Healthcare Provider Details

I. General information

NPI: 1992292213
Provider Name (Legal Business Name): HUI TUNG TONY LIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TONY LIN MD

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 GRIDER ST
BUFFALO NY
14215-3098
US

IV. Provider business mailing address

77 GOODELL ST STE 220
BUFFALO NY
14203-1243
US

V. Phone/Fax

Practice location:
  • Phone: 716-898-3000
  • Fax:
Mailing address:
  • Phone:
  • 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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number310834
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number310834
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number310834
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: