Individual provider Active NPI

Phyllis S Lam, LIC, AC

  • Acupuncturist
  • New York, NY
National Provider Identifier
1215496922
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
004764-1 Issued in NY
Practice address
20 E 46TH St RM 1402
New York, NY 10017-9244
Phone
(212) 573-9584
NPI assigned
Mar 13, 2019
Last updated
Mar 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 004764-1 NY Primary

Addresses

Primary practice location

20 E 46TH St RM 1402
New York, NY 10017-9244

Mailing address

3 Grosvenor PL
Great Neck, NY 11021-4534
Phone (347) 576-4224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
004764-1NYMDAcupuncturist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1215496922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 GROSVENOR PL",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214534",
            "telephone_number": "347-576-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E 46TH ST RM 1402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100179244",
            "telephone_number": "212-573-9584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "PHYLLIS",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "LIC, AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "004764-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.