Provider Demographics
NPI:1376595736
Name:LAM, SOFIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SOFIA
Middle Name:
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 1:101 OLD YORK ROAD SUITE 100
Mailing Address - Street 2:SUBURBAN PAIN CONTROL CENTER
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046
Mailing Address - Country:US
Mailing Address - Phone:215-886-7856
Mailing Address - Fax:215-885-8861
Practice Address - Street 1:101 OLD YORK ROAD SUITE 100
Practice Address - Street 2:SUBURBAN PAIN CONTROL CENTER
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:215-886-7856
Practice Address - Fax:215-885-8861
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036352E207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA594859Medicare PIN
PAE52964Medicare UPIN