Healthcare Provider Details

I. General information

NPI: 1316442510
Provider Name (Legal Business Name): PHILIP S LIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WOODS RD
VALHALLA NY
10595-1530
US

IV. Provider business mailing address

30 JOHNSON AVE
ENGLEWOOD CLIFFS NJ
07632-2108
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-7000
  • Fax:
Mailing address:
  • Phone: 201-655-2030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number322153
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: