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General NPI Number Information
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NPI Number | 1659453934
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Entity Type | Individual
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Provider Name | ANTOINE LIN MPT, CSCS
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Gender | Male
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 626 RIDGE RD
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City | LYNDHURST
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State | NJ
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Zip | 07071-3206
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Country | US
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Telephone | 201-372-3240
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Fax | 201-939-6404
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Provider Business Mailing Address
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Address Line | 77 FRANCISCO AVE
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City | RUTHERFORD
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State | NJ
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Zip | 07070-1637
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 40QA00967000
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License Number State | NJ
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