MEDICARE: JEROD 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	163W00000X	Registered Nurse	RN2390100	MA

General Provider Information

NPI Number	:	1396677142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEROD LIN

Provider Business Mailing Address
First Line	:	29 N PAYNE ST
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169-7812
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	29 N PAYNE ST
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169-7812
Country	:	US
Telephone Number	:	617-645-8572
Fax Number	:

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “ JEROD LIN ” Practice Location

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