Healthcare Provider Details

I. General information

NPI: 1316493364
Provider Name (Legal Business Name): HADASSAH LAMM CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2016
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1999 MARCUS AVE STE 200
NEW HYDE PARK NY
11042-1021
US

IV. Provider business mailing address

1256 BEACH 12TH ST 2D
FAR ROCKAWAY NY
11691-4710
US

V. Phone/Fax

Practice location:
  • Phone: 516-663-4600
  • Fax:
Mailing address:
  • Phone: 718-887-4993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number382680
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number626486
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: