Basic Information
| Provider Information | |||||||||
| NPI: | 1720228562 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIN | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 FROEHLICH FARM BLVD | ||||||||
| Address2: | |||||||||
| City: | WOODBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117972922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163645400 | ||||||||
| FaxNumber: | 5169414889 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 FROEHLICH FARM BLVD | ||||||||
| Address2: | |||||||||
| City: | WOODBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117972922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163645400 | ||||||||
| FaxNumber: | 5169414889 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2009 | ||||||||
| LastUpdateDate: | 05/03/2012 | ||||||||
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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 | 207W00000X | 252183 | NY | Y | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 25MA09067200 | NJ | N | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.