Provider Demographics
NPI:1780667956
Name:LAMM, JOEL LEWIS (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:LEWIS
Last Name:LAMM
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 1:400 S OYSTER BAY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3500
Mailing Address - Country:US
Mailing Address - Phone:516-933-1717
Mailing Address - Fax:516-933-6851
Practice Address - Street 1:400 S OYSTER BAY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3500
Practice Address - Country:US
Practice Address - Phone:516-933-1717
Practice Address - Fax:516-933-6851
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142546207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
19D241Medicare ID - Type Unspecified
A61080Medicare UPIN