Provider Demographics
NPI:1457596363
Name:LAM, SOPHAL (NP)
Entity type:Individual
Prefix:
First Name:SOPHAL
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:585-597 MERRIMACK ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-3908
Mailing Address - Country:US
Mailing Address - Phone:978-746-7862
Mailing Address - Fax:978-275-9890
Practice Address - Street 1:759 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1619
Practice Address - Country:US
Practice Address - Phone:413-794-5307
Practice Address - Fax:413-794-8430
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2025-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN280635363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner