Basic Information
| Provider Information | |||||||||
| NPI: | 1124292479 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MA | ||||||||
| FirstName: | THIN-SU-LIN | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 789 CENTRAL AVENUE | ||||||||
| Address2: | BUSINESS OFFICE | ||||||||
| City: | DOVER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038202526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037404478 | ||||||||
| FaxNumber: | 6037402244 | ||||||||
| Practice Location | |||||||||
| Address1: | 789 CENTRAL AVENUE | ||||||||
| Address2: | |||||||||
| City: | DOVER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038202526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037404478 | ||||||||
| FaxNumber: | 6037402244 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2008 | ||||||||
| LastUpdateDate: | 12/07/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 058684-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 433929199 | 05 | ME | MEDICAID | 30347745 | 05 | NH | MEDICAID | P00811644 | 01 | NH | RR MEDICARE | OTHER |