Provider Demographics
NPI:1760212625
Name:FU, KAI LIN (PSYD)
Entity type:Individual
Prefix:
First Name:KAI LIN
Middle Name:
Last Name:FU
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 WADSWORTH TER APT 4C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3081
Mailing Address - Country:US
Mailing Address - Phone:347-602-3232
Mailing Address - Fax:
Practice Address - Street 1:64 WADSWORTH TER APT 4C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-3081
Practice Address - Country:US
Practice Address - Phone:347-602-3232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026519-01103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical