MEDICARE: DR. KIT LIN LYDIA TAM PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	55318	CA
2	183500000X	Pharmacist	118024	MN
3	183500000X	Pharmacist	054123	NY

General Provider Information

NPI Number	:	1487977542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIT LIN LYDIA TAM PHARM.D.

Provider Business Mailing Address
First Line	:	155 E 34TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-4766
Country	:	US
Telephone Number	:	212-683-3042
Fax Number	:

Provider Business Practice Location Address
First Line	:	545 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-3501
Country	:	US
Telephone Number	:	212-696-5081
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2010
Last Update Date	:	11/23/2016

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