Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 132757-1 | NY |
NPI | 1003857392 |
---|---|
Provider Name | Patrick Ki-Cheong Lam |
First Address | Woodbury, NJ 08096-2739 |
Second Address | Kingston, NY 12401-4652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 12/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01976961 | (05) | NY |
C87542 | (02) |