Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 239381 | NY |
NPI | 1043265747 |
---|---|
Provider Name | Po N Lam |
First Address | Syracuse, NY 13210-1155 |
Second Address | Syracuse, NY 13210-1155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 22/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RB5938 | (02) | NY |