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General NPI Number Information
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NPI Number | 1538395074
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Entity Type | Organization
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Legal Business Name | BLAM MEDICAL PC
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Dates
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Enumeration Date | 06/10/2009
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 16411 CHAPIN PKWY
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City | JAMAICA
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State | NY
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Zip | 11432-1816
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Country | US
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Telephone | 917-834-0615
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Fax |
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Provider Business Mailing Address
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Address Line | 6832 DARTMOUTH ST
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City | FOREST HILLS
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State | NY
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Zip | 11375-5047
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Country | US
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Telephone | 917-834-0615
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BINH V LAM
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Credential | MD
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Telephone | 917-834-0615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 224601
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License Number State | NY
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