Provider Demographics
NPI:1063572907
Name:LIN, JULIE HSIAO-WEN (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:HSIAO-WEN
Last Name:LIN
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 1:53 FAIRFAX RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-4405
Mailing Address - Country:US
Mailing Address - Phone:833-688-3376
Mailing Address - Fax:
Practice Address - Street 1:53 FAIRFAX RD STE 2
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-4405
Practice Address - Country:US
Practice Address - Phone:833-688-3376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD436030207N00000X
VT042-0011829207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology