Provider Demographics
NPI:1982194346
Name:LIN, JEAN (OT)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:LIN
Suffix:
Gender:
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-9709
Mailing Address - Country:US
Mailing Address - Phone:862-579-5653
Mailing Address - Fax:877-407-4329
Practice Address - Street 1:201 LITTLETON RD STE 150
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-2939
Practice Address - Country:US
Practice Address - Phone:973-627-0055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00827400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist