Provider Demographics
NPI:1245301431
Name:LAM, RIA YABUT SANTOS (ANP)
Entity type:Individual
Prefix:MRS
First Name:RIA
Middle Name:YABUT SANTOS
Last Name:LAM
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MS
Other - First Name:RIA
Other - Middle Name:YABUT
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 SALMON CT
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-2821
Mailing Address - Country:US
Mailing Address - Phone:646-226-7871
Mailing Address - Fax:
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:646-226-7871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22 515438163W00000X
NJ26NR11336800163W00000X
NYF304451363LA2200X
NJ26NJ00118300363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse