Healthcare Provider Details

I. General information

NPI: 1114478476
Provider Name (Legal Business Name): MS. TSERING LHAMO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9030 53RD AVE APT 3
ELMHURST NY
11373-4540
US

IV. Provider business mailing address

9030 53RD AVE APT 3 FLOOR
ELMHURST NY
11373-4540
US

V. Phone/Fax

Practice location:
  • Phone: 347-421-2924
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF307848
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: