Provider Demographics
NPI:1023766805
Name:LAM, TIM GIT SIMON (MHC-LP)
Entity type:Individual
Prefix:
First Name:TIM GIT
Middle Name:SIMON
Last Name:LAM
Suffix:
Gender:M
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 MACE AVE APT 2K
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-1083
Mailing Address - Country:US
Mailing Address - Phone:347-282-3478
Mailing Address - Fax:
Practice Address - Street 1:2417 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-6331
Practice Address - Country:US
Practice Address - Phone:800-421-2031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health