Provider Demographics
NPI:1053518548
Name:LIN, YA LI (MD)
Entity type:Individual
Prefix:
First Name:YA
Middle Name:LI
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HNIN
Other - Middle Name:MAR
Other - Last Name:AUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:13232 MAPLE AVE
Mailing Address - Street 2:APT B
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4876
Mailing Address - Country:US
Mailing Address - Phone:718-353-0555
Mailing Address - Fax:718-353-0566
Practice Address - Street 1:13232 MAPLE AVE
Practice Address - Street 2:APT B
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4876
Practice Address - Country:US
Practice Address - Phone:718-353-0555
Practice Address - Fax:718-353-0566
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252343207R00000X
CAA99719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine