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General NPI Number Information
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NPI Number | 1891083507
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Entity Type | Individual
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Provider Name | ELAINE LIN O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 92 ROUTE 23 NORTH
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City | RIVERDALE
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State | NJ
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Zip | 07457
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Country | US
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Telephone | 973-248-1188
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Fax |
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Provider Business Mailing Address
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Address Line | 12 LYNDEN CT
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City | SPRING VALLEY
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State | NY
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Zip | 10977-2351
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Country | US
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Telephone | 845-426-1060
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 007725
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00640000
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License Number State | NJ
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