Healthcare Provider Details
I. General information
NPI: 1801885447
Provider Name (Legal Business Name): DEBORAH LIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/17/2005
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
125 WALKER ST FL 2
NEW YORK NY
10013-4135
US
IV. Provider business mailing address
125 WALKER ST FL 2
NEW YORK NY
10013-4135
US
V. Phone/Fax
- Phone: 212-226-3888
- Fax: 212-334-6887
- Phone: 212-226-8866
- Fax: 212-226-2289
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0201X |
| Taxonomy | Pediatric Allergy/Immunology Physician |
| License Number | 201700 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 201700 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: