Provider Demographics
NPI:1154353332
Name:YIN, JUNE (MD)
Entity type:Individual
Prefix:DR
First Name:JUNE
Middle Name:
Last Name:YIN
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 1:13620 38TH AVE STE 6G
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4263
Mailing Address - Country:US
Mailing Address - Phone:718-888-0968
Mailing Address - Fax:718-888-1506
Practice Address - Street 1:13620 38TH AVE STE 6G
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4263
Practice Address - Country:US
Practice Address - Phone:718-888-0968
Practice Address - Fax:718-888-1506
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207864174400000X
NYA2078642084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01974836Medicaid
NY01974836Medicaid
NY06430Medicare PIN