Provider Demographics
NPI:1174583298
Name:LIN, JUN (MD)
Entity type:Individual
Prefix:DR
First Name:JUN
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:STONY BROOK UNIVERSITY HSC LEVEL 4 # 060
Mailing Address - Street 2:STONY BROOK ANAESTHESIOLOGY, UFPC
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8480
Mailing Address - Country:US
Mailing Address - Phone:631-444-2975
Mailing Address - Fax:631-444-2907
Practice Address - Street 1:STONY BROOK UNIVERSITY HSC LEVEL 4 # 060
Practice Address - Street 2:STONY BROOK ANAESTHESIOLOGY, UFPC
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8480
Practice Address - Country:US
Practice Address - Phone:631-444-2975
Practice Address - Fax:631-444-2907
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2013-09-16
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Provider Licenses
StateLicense IDTaxonomies
NY217047-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02086400Medicaid
NYH30600Medicare UPIN
NY02086400Medicaid