Provider Demographics
NPI:1669629663
Name:LAM-RACHLIN, JENNIFER CHIUNG (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CHIUNG
Last Name:LAM-RACHLIN
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 1:70 E 90TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1233
Mailing Address - Country:US
Mailing Address - Phone:212-722-7409
Mailing Address - Fax:
Practice Address - Street 1:70 E 90TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1233
Practice Address - Country:US
Practice Address - Phone:212-722-7409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301098162207VM0101X
390200000X
NY274992207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program