Provider Demographics
NPI:1528309192
Name:LIN, WEN FENG (LAC, LMT)
Entity type:Individual
Prefix:
First Name:WEN
Middle Name:FENG
Last Name:LIN
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8337 ST. JAMES AVE
Mailing Address - Street 2:APT: 1G
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373
Mailing Address - Country:US
Mailing Address - Phone:917-420-5732
Mailing Address - Fax:
Practice Address - Street 1:363 7TH AVE
Practice Address - Street 2:SUITE 1501
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3904
Practice Address - Country:US
Practice Address - Phone:917-420-5732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004744171100000X
NY025112174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No174400000XOther Service ProvidersSpecialist