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Individual

LUIS LAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7516 BAY PARKWAY, UNIT CF#3, BROOKLYN, NY 11214
(585) 421-7732
Mailing address
7516 BAY PARKWAY, UNIT CF#3, BROOKLYN, NY 11214
(585) 421-7732

Taxonomy

Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
852916217
NY
Enumeration date
06/15/2021
Last updated
06/15/2021
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