MEDICARE: QUEENA 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	363A00000X	Physician Assistant	MA067260	PA

General Provider Information

NPI Number	:	1376374058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUEENA LIN

Provider Business Mailing Address
First Line	:	52 MADISON LN
Second Line	:
City	:	WHITEHALL
State	:	PA
Zip	:	18052-3749
Country	:	US
Telephone Number	:	610-504-8752
Fax Number	:

Provider Business Practice Location Address
First Line	:	575 S 9TH ST
Second Line	:
City	:	LEHIGHTON
State	:	PA
Zip	:	18235-2517
Country	:	US
Telephone Number	:	484-503-4673
Fax Number	:

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

Provider Enumeration Date	:	08/13/2024
Last Update Date	:	01/06/2026

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Directions to “ QUEENA LIN ” Practice Location

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