Individual
FONG LAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 55TH ST, BROOKLYN, NY 11220-2508
(917) 669-4905
Mailing address
150 55TH ST, BROOKLYN, NY 11220-2508
(917) 669-4905
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
348643
NY
Other
Enumeration date
11/17/2021
Last updated
11/17/2021
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