MEDICARE: FANG LIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	0470901	NY

General Provider Information

NPI Number	:	1003138462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FANG LIN

Provider Business Mailing Address
First Line	:	241 BAY 13TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-5807
Country	:	US
Telephone Number	:	646-322-2981
Fax Number	:

Provider Business Practice Location Address
First Line	:	241 BAY 13TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-5807
Country	:	US
Telephone Number	:	646-322-2981
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2010
Last Update Date	:	02/25/2010

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Directions to “ FANG LIN ” Practice Location

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