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General NPI Number Information
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NPI Number | 1801330501
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Entity Type | Individual
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Provider Name | LUT LAM TSOI RPH
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Gender | Female
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Dates
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Enumeration Date | 12/14/2016
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 236 MAIN ST
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City | NEW PALTZ
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State | NY
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Zip | 12561-1314
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Country | US
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Telephone | 614-962-3406
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Fax |
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Provider Business Mailing Address
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Address Line | 124 WAVERLY ST
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City | EVERETT
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State | MA
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Zip | 02149-2825
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Country | US
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Telephone | 614-962-3406
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 062400
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License Number State | NY
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