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General NPI Number Information
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NPI Number | 1689963753
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Entity Type | Individual
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Provider Name | JUAN LIN D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2011
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 101 SAINT ANDREWS LN
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City | GLEN COVE
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State | NY
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Zip | 11542-2254
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Country | US
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Telephone | 631-997-8768
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Fax |
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Provider Business Mailing Address
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Address Line | 9 SUNRISE ST
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City | PLAINVIEW
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State | NY
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Zip | 11803-4612
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Country | US
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Telephone | 631-997-8768
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 276056
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 276056
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License Number State | NY
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