Healthcare Provider Details

I. General information

NPI: 1295544716
Provider Name (Legal Business Name): TASHI LHAMO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2024
Last Update Date: 12/31/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 30TH AVE
LONG ISLAND CITY NY
11102-2448
US

IV. Provider business mailing address

10202 63RD AVE
FOREST HILLS NY
11375-1046
US

V. Phone/Fax

Practice location:
  • Phone: 718-932-1000
  • Fax:
Mailing address:
  • Phone: 860-823-9963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: