Healthcare Provider Details

I. General information

NPI: 1811322076
Provider Name (Legal Business Name): INGHWA HSU-LAM RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2013
Last Update Date: 09/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442 BALLTOWN RD
SCHENECTADY NY
12304-2245
US

IV. Provider business mailing address

34 RUNNEL DR
SCHENECTADY NY
12304-4813
US

V. Phone/Fax

Practice location:
  • Phone: 518-346-6218
  • Fax: 518-346-6384
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI42830-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: