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General NPI Number Information
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NPI Number | 1518173046
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Entity Type | Individual
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Provider Name | MISS PORTIA LAM
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 163-03 HORACE HARDING EXP 2/F
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City | FRESH MEADOWS
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State | NY
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Zip | 11365
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Country | US
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Telephone | 718-353-0530
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Fax |
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Provider Business Mailing Address
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Address Line | 163-03 HORACE HARDING EXP 2/F
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City | FRESH MEADOWS
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State | NY
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Zip | 11365
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Country | US
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Telephone | 718-353-0530
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 015505
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License Number State | NY
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