Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 72236 | MA |
N | 208000000X | Pediatrician | 72236 | MA |
NPI | 1770565855 |
---|---|
Provider Name | Dr. Angela E Lin |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2696 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 15/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
072236 | TUFTS HEALTH PLAN (01) | MA |
3077691 | (05) | MA |
E75422 | (02) | |
J10829 | BCBS MA (01) | MA |