Provider Demographics
NPI:1205832185
Name:LAM, LING L (MD)
Entity Type:Individual
Prefix:
First Name:LING
Middle Name:L
Last Name:LAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:579A CRANBURY RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5426
Mailing Address - Country:US
Mailing Address - Phone:732-390-0040
Mailing Address - Fax:732-390-1856
Practice Address - Street 1:3900 PARK AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3032
Practice Address - Country:US
Practice Address - Phone:732-548-6800
Practice Address - Fax:732-548-6290
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA070814002085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ300111741OtherRAILROAD MEDICARE - WARREN
NJ300111741OtherRAILROAD MEDICARE - EDISON
NJ8235708Medicaid
NJ300111741OtherRAILROAD MEDICARE - SMC
NJ300111741OtherRAILROAD MEDICARE - BRIDGEWATER
NJH17753Medicare UPIN
NJ300111741OtherRAILROAD MEDICARE - SMC