Provider Demographics
NPI:1992333991
Name:JIN, ANNIE (MD)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:JIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 BENJAMIN FRANKLIN HWY EAST
Mailing Address - Street 2:
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508
Mailing Address - Country:US
Mailing Address - Phone:610-620-2402
Mailing Address - Fax:877-437-7288
Practice Address - Street 1:3760 BROOKSIDE RD
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-1741
Practice Address - Country:US
Practice Address - Phone:610-770-2708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD488060207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology