Provider Demographics
NPI:1679782817
Name:LIN, JIAN LE (MD)
Entity type:Individual
Prefix:DR
First Name:JIAN
Middle Name:LE
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:125 TERRYVILLE RD
Mailing Address - Street 2:APT # 14C
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-1300
Mailing Address - Country:US
Mailing Address - Phone:716-982-3357
Mailing Address - Fax:
Practice Address - Street 1:97 W PARKWAY
Practice Address - Street 2:DEPT. OF ANESTHESIA
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1647
Practice Address - Country:US
Practice Address - Phone:973-831-5093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08213800207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology