Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP0504X | Public Medicine | N005232 | NY |
Y | 213EP1101X | Primary Podiatric Medicine | N005232 | NY |
N | 213ES0131X | Foot Surgery | N005232 | NY |
NPI | 1407946601 |
---|---|
Provider Name | Dr. Timothy Gary Lam |
First Address | Schenectady, NY 12309-6113 |
Second Address | Schenectady, NY 12309-6113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 22/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01619667 | (05) | NY |
U59439 | UPIN (01) | NY |