Individual
MS. IDA MAN SHAN LAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4110 BOWNE ST, STE L3, FLUSHING, NY 11355-5606
(718) 961-1496
(718) 961-1494
Mailing address
4110 BOWNE ST, STE L3, FLUSHING, NY 11355-5606
(718) 961-1496
(718) 961-1494
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1020937
NY
Other
Enumeration date
03/25/2013
Last updated
11/30/2018
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