Da-nutrition Pllc | |
41-10 Browne Street, Ste L3 Flushing NY 11355 | |
(718) 961-1496 | |
(718) 961-1494 |
Full Name | Da-nutrition Pllc |
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Speciality | Clinic/Center |
Location | 41-10 Browne Street, Ste L3, Flushing, New York |
Authorized Official Name and Position | Ida Man Shan Lam (OWNER/MANAGER) |
Authorized Official Contact | 7189611496 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Da-nutrition Pllc 41-10 Browne Street, Ste L3 Flushing NY 11355 Ph: (718) 961-1496 | Da-nutrition Pllc 41-10 Browne Street, Ste L3 Flushing NY 11355 Ph: (718) 961-1496 |
NPI Number | 1689916934 |
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Provider Enumeration Date | 03/25/2013 |
Last Update Date | 06/29/2018 |
Medicare PECOS PAC ID | 2567685118 |
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Medicare Enrollment ID | O20140529000016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689916934 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Ida Man Shan Lam |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1407198724 PECOS PAC ID: 3476776022 Enrollment ID: I20140529000038 |
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