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Individual
DR. IVAN TAM
Active
Individual
DR. IVAN TAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
047376
NY
225100000X
Physical Therapist
26504
MA
225100000X
Physical Therapist
40QA02326900
NJ
Other
Enumeration date
11/03/2021
Last updated
09/26/2025
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