Provider Demographics
NPI:1578900262
Name:PO CHI LAM CLINIC INC
Entity Type:Organization
Organization Name:PO CHI LAM CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:GALE
Authorized Official - Middle Name:E
Authorized Official - Last Name:TALMADGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-425-0774
Mailing Address - Street 1:224 BROADWAY FL 1
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-4331
Mailing Address - Country:US
Mailing Address - Phone:860-425-0774
Mailing Address - Fax:
Practice Address - Street 1:83 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-2423
Practice Address - Country:US
Practice Address - Phone:860-443-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT532171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty