MEDICARE: WEN FENG LIN LAC, LMT

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	171100000X	Acupuncturist	004744	NY
2	174400000X	Specialist	025112	NY

General Provider Information

NPI Number	:	1528309192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WEN FENG LIN LAC, LMT

Provider Business Mailing Address
First Line	:	8337 ST. JAMES AVE
Second Line	:	APT: 1G
City	:	ELMHURST
State	:	NY
Zip	:	11373
Country	:	US
Telephone Number	:	917-420-5732
Fax Number	:

Provider Business Practice Location Address
First Line	:	363 7TH AVE
Second Line	:	SUITE 1501
City	:	NEW YORK
State	:	NY
Zip	:	10001-3904
Country	:	US
Telephone Number	:	917-420-5732
Fax Number	:

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

Provider Enumeration Date	:	03/07/2013
Last Update Date	:	01/26/2015

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