# DR. IVAN LAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1366859761
- **Gender:** Man
- **Credential:** DC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 012540 | NY | Yes |
| 111N00000X | Chiropractor | X012540-1 | NY | — |

## Other

- **Enumeration date:** 07/17/2014
- **Last updated:** 08/20/2019