MEDICARE: LINLI YAN-ROSENBERG, PHYSICIAN, P.C.

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	261Q00000X	Clinic/Center	243626	NY

General Provider Information

NPI Number	:	1336388057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINLI YAN-ROSENBERG, PHYSICIAN, P.C.

Provider Business Mailing Address
First Line	:	825 57TH ST
Second Line	:	SUITE 102
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3648
Country	:	US
Telephone Number	:	718-676-1550
Fax Number	:	718-676-1553

Provider Business Practice Location Address
First Line	:	825 57TH ST
Second Line	:	SUITE 102
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3648
Country	:	US
Telephone Number	:	718-676-1550
Fax Number	:	718-676-1553

Authorized Official
Title or Position	:	PRESITENT/DIRECTOR
Name	:	LINLI YAN-ROSENBERG
Credential	:	M.D.
Telephone Number	:	19175738506

Provider Enumeration Date	:	02/19/2009
Last Update Date	:	01/19/2012

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