Ida Man Shan Lam, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1020937 Issued in NY

Practice address

4110 Bowne St
Ste L3
Flushing, NY 11355-5606

Phone

(718) 961-1496

Fax

(718) 961-1494

NPI assigned

Mar 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Master of Science

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Da-Nutrition PLLC

  • Clinic/Center
  • Flushing, NY
  • NPI 1689916934
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1407198724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 BOWNE ST",
            "address_2": "STE L3",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555606",
            "telephone_number": "718-961-1496",
            "fax_number": "718-961-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 BOWNE ST",
            "address_2": "STE L3",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555606",
            "telephone_number": "718-961-1496",
            "fax_number": "718-961-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "IDA",
        "middle_name": "MAN SHAN",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "1020937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Lam, DDS
• Diana Lam, NP
• Diane Lam, M.D.
• Henry Lam, MD
• Heung Lam
• Janet Lam, OD
• Justin Lam
• Maureen Lam, DDS
• Wai-Kuen Lam, M.D.
• Yuk Lam

• Registered Dietitian in Flushing, NY
• Providers in Flushing, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.