Provider Demographics
NPI:1285887893
Name:LAM, CHUNG LUI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHUNG
Middle Name:LUI
Last Name:LAM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4630 KISSENA BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3421
Mailing Address - Country:US
Mailing Address - Phone:718-888-1918
Mailing Address - Fax:718-888-9348
Practice Address - Street 1:4630 KISSENA BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3421
Practice Address - Country:US
Practice Address - Phone:718-888-1918
Practice Address - Fax:718-888-9348
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048944183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist