Individual
LIN N OO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1922 E 16TH ST FL 11922E16, BROOKLYN, NY 11229-3402
(516) 513-4347
Mailing address
1922 E 16TH ST FL 11922E16, BROOKLYN, NY 11229-3402
(516) 513-4347
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
LA-1748865
NY
Other
Enumeration date
07/05/2025
Last updated
07/05/2025
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