Provider Demographics
NPI:1629174644
Name:THAM, NANCY (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:THAM
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 E 142ND ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-2110
Mailing Address - Country:US
Mailing Address - Phone:718-579-4000
Mailing Address - Fax:
Practice Address - Street 1:545 E 142ND ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-2110
Practice Address - Country:US
Practice Address - Phone:718-579-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ57324207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1619148160OtherFACILITY NPI
NJ6282903Medicaid
NJ1235300799OtherFACILITY NPI
NJ1932370483OtherFACILITY NPI
NJ1972778413OtherFACILITY NPI
NJ1194996645OtherFACILITY NPI
NJ1548431091OtherFACILITY NPI
NJ1740345693OtherFACILITY NPI
NJ1063683258OtherFACILITY NPI
NJ1194996645OtherFACILITY NPI
NJ1740345693OtherFACILITY NPI