Healthcare Provider Details

I. General information

NPI: 1659892255
Provider Name (Legal Business Name): MICHAEL DAVID LAMB CPNP-PC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST # 99
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

2821 46TH ST APT 1
ASTORIA NY
11103-1209
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-2363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number382819
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number717647
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: