Provider Demographics
NPI:1649377565
Name:CHOI & TAM INC
Entity type:Organization
Organization Name:CHOI & TAM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WYNNE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:KWOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-966-9239
Mailing Address - Street 1:9 ELIZABETH ST
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4111
Mailing Address - Country:US
Mailing Address - Phone:212-966-9239
Mailing Address - Fax:212-219-0857
Practice Address - Street 1:9 ELIZABETH ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4111
Practice Address - Country:US
Practice Address - Phone:212-966-9239
Practice Address - Fax:212-219-0857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336S0011X, 332B00000X, 333600000X
NY0249943336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02551242Medicaid
2064133OtherPK
4506030001Medicare NSC