Individual
DR. JEANNIE TAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
451 CLARKSON AVE, BROOKLYN, NY 11203-2054
(718) 245-7187
Mailing address
123 W 93RD ST, NEW YORK, NY 10025-7572
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
213626
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02271043
—
NY
Enumeration date
01/24/2007
Last updated
03/19/2021
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