Provider Demographics
NPI:1225128440
Name:LAM FAMILY FOOT CARE, PLLC
Entity Type:Organization
Organization Name:LAM FAMILY FOOT CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:LAM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:518-370-3668
Mailing Address - Street 1:1610 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-6113
Mailing Address - Country:US
Mailing Address - Phone:518-370-3668
Mailing Address - Fax:518-370-7162
Practice Address - Street 1:1610 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-6113
Practice Address - Country:US
Practice Address - Phone:518-370-3668
Practice Address - Fax:518-370-7162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005232213EP0504X, 213EP1101X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic MedicineGroup - Single Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01619667Medicaid
NY5429300001Medicare NSC
NYBA0582Medicare PIN
NYRA7104Medicare PIN