Provider Demographics
NPI:1841023546
Name:LAM, JOHN (RN)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:LAM
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237-28 93 AVENUE
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426
Mailing Address - Country:US
Mailing Address - Phone:917-902-6791
Mailing Address - Fax:
Practice Address - Street 1:237-28 93 AVENUE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426
Practice Address - Country:US
Practice Address - Phone:917-902-6791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY727874163W00000X
CA95279275163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse