Provider Demographics
NPI:1659371078
Name:LAM, TERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:
Last Name:LAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 BOWERY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4614
Mailing Address - Country:US
Mailing Address - Phone:212-966-8823
Mailing Address - Fax:212-966-8881
Practice Address - Street 1:80 BOWERY
Practice Address - Street 2:SUITE 600
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4614
Practice Address - Country:US
Practice Address - Phone:212-966-8823
Practice Address - Fax:212-966-8881
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205931207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2112039OtherUNITED HEALTHCARE PPO
NY2793417OtherAETNA HMO
NY0408498OtherUNITED HEALTHCARE
NY02179500Medicaid
NY9438201 005OtherCIGNA
NY205931OtherHIP
NY2593144OtherGHI
NY205931-A20OtherHEALTHFIRST
NY122AG1OtherBLUECROSS BLUESHIELD #
NY7422324OtherAETNA PPO/POS
NYP2525615OtherOXFORD PROVIDER NUMBER
NY9438201 005OtherCIGNA
NYP2525615OtherOXFORD PROVIDER NUMBER
NY7422324OtherAETNA PPO/POS