Provider Demographics
NPI:1619978582
Name:LIN, YANN YANN (MD)
Entity type:Individual
Prefix:DR
First Name:YANN YANN
Middle Name:
Last Name:LIN
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 1:366 EAGLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-5304
Mailing Address - Country:US
Mailing Address - Phone:410-255-8985
Mailing Address - Fax:
Practice Address - Street 1:366 EAGLE HILL RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-5304
Practice Address - Country:US
Practice Address - Phone:410-255-8985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047158208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD82094305OtherCAREFIRST BCBSMD
DCG859-0003OtherCAREFIRST BCBSNCA
MD133002100Medicaid