MEDICARE: ANDREW ZAW LIN M.D.

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	207R00000X	Internal Medicine Physician	200292	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110139687	OTHER	NY	RR MEDICARE

General Provider Information

NPI Number	:	1831152586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW ZAW LIN M.D.

Provider Business Mailing Address
First Line	:	11 SWEET BRIAR PATH
Second Line	:
City	:	LAKE GROVE
State	:	NY
Zip	:	11755-1850
Country	:	US
Telephone Number	:	631-689-8889
Fax Number	:	631-689-8882

Provider Business Practice Location Address
First Line	:	365 E MAIN ST
Second Line	:
City	:	PATCHOGUE
State	:	NY
Zip	:	11772-3145
Country	:	US
Telephone Number	:	631-854-1300
Fax Number	:	631-854-1269

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	12/06/2012

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