MEDICARE: VIVIAN LAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WL0500X	Low Vision Rehabilitation Optometrist	0618003536	VA
2	152WP0200X	Pediatric Optometrist	0618003536	VA
3	152W00000X	Optometrist	0618003536	VA

General Provider Information

NPI Number	:	1982594586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVIAN LAM

Provider Business Mailing Address
First Line	:	25055 RIDING PLZ STE 100
Second Line	:
City	:	CHANTILLY
State	:	VA
Zip	:	20152-5918
Country	:	US
Telephone Number	:	703-957-3384
Fax Number	:

Provider Business Practice Location Address
First Line	:	25055 RIDING PLZ STE 100
Second Line	:
City	:	CHANTILLY
State	:	VA
Zip	:	20152-5918
Country	:	US
Telephone Number	:	703-957-3384
Fax Number	:	703-957-3387

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2025
Last Update Date	:	07/07/2025

Similar Medicare Providers

1902831134 — DR. DIMPLE KAPOOR O.D.
Practice Location Address:

25055 RIDING PLZ STE 100
CHANTILLY, VA
20152-5918

Practice Phone: 703-961-9119
Practice Fax: 703-961-9230

1477759298 — DR. NEAL D. KRAVITZ DMD, MS
Practice Location Address:

25055 RIDING PLAZA , SUITE 110
CHANTILLY, VA
20152-5918

Practice Phone: 703-722-2900
Practice Fax: 703-722-2903

1073403440 — NEGIN AZHANDEH O.D.
Practice Location Address:

25055 RIDING PLZ STE 100
CHANTILLY, VA
20152-5918

Practice Phone: 703-957-3384
Practice Fax: 703-957-3387

1285736454 — DR. SYLVIA J BRICENO O.D.
Practice Location Address:

25055 RIDING PLZ STE 100
SOUTH RIDING, VA
20152-5918

Practice Phone: 703-961-9119
Practice Fax: 703-961-9230

1952240996 — RESILIENT PHYSICAL THERAPY LLC
Practice Location Address:

43172 KATAMA SQ
CHANTILLY, VA
20152-4471

Practice Phone: 703-389-3980
Practice Fax:

1023957958 — SOHAIL MAIWAND DMD
Practice Location Address:

26629 MARBURY ESTATES DR
CHANTILLY, VA
20152-6420

Practice Phone: 703-401-0222
Practice Fax:

Directions to “ VIVIAN LAM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.