Provider Demographics
NPI:1265786057
Name:LIN, XIAO LI (PA)
Entity type:Individual
Prefix:
First Name:XIAO
Middle Name:LI
Last Name:LIN
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Gender:F
Credentials:PA
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Mailing Address - Street 1:13620 MAPLE AVE # C702
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5166
Mailing Address - Country:US
Mailing Address - Phone:347-368-4288
Mailing Address - Fax:347-368-4785
Practice Address - Street 1:13620 MAPLE AVE # C702
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5166
Practice Address - Country:US
Practice Address - Phone:347-368-4288
Practice Address - Fax:347-368-4785
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-01
Last Update Date:2025-06-06
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Provider Licenses
StateLicense IDTaxonomies
NY016195363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical