| Da-nutrition Pllc | |
|
41-10 Browne Street, Ste L3 Flushing NY 11355 | |
| (718) 961-1496 | |
| (718) 961-1494 |
| Full Name | Da-nutrition Pllc |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 03/25/2013 |
| Last Update Date | 06/29/2018 |
| Medicare PECOS PAC ID | 2567685118 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1407198724 PECOS PAC ID: 3476776022 Enrollment ID: I20140529000038 |
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