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General NPI Number Information
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NPI Number | 1891074902
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Entity Type | Organization
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Legal Business Name | LAM QUAN, M.D., P.C.
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Dates
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Enumeration Date | 08/06/2011
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Last Update Date | 07/07/2012
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Provider Practice Location Address
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Address Line | 1302 GRAND AVE
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-1418
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Country | US
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Telephone | 516-223-7533
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Fax | 516-223-7534
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Provider Business Mailing Address
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Address Line | 27 SUNNYSIDE BLVD
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City | PLAINVIEW
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State | NY
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Zip | 11803-1510
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Country | US
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Telephone | 917-670-3530
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Fax | 516-576-0691
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAM CU QUAN
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Credential | M.D.
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Telephone | 917-670-3530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number | A241419
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License Number State | NY
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