Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 241419 | NY |
NPI | 1053531921 |
---|---|
Provider Name | Dr. Lam Cu Quan |
First Address | Plainview, NY 11803-1510 |
Second Address | North Baldwin, NY 11510-1418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 15/07/2012 |