MEDICARE: MS. LINLIN JIANG

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	225100000X	Physical Therapist	40QA01119000	NJ

General Provider Information

NPI Number	:	1558577049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINLIN JIANG

Provider Business Mailing Address
First Line	:	101 SARATOGA SQ
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-6349
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 HAMBURG TPKE
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-2019
Country	:	US
Telephone Number	:	973-595-5419
Fax Number	:

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

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	07/08/2007

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