Provider Demographics
NPI:1760635015
Name:LAM, PHIEU S (ND)
Entity Type:Individual
Prefix:DR
First Name:PHIEU
Middle Name:S
Last Name:LAM
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 78TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1156
Mailing Address - Country:US
Mailing Address - Phone:347-216-1496
Mailing Address - Fax:
Practice Address - Street 1:670 NEWFIELD ST UNIT C
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-1867
Practice Address - Country:US
Practice Address - Phone:860-347-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000307175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath