Provider Demographics
NPI:1336590421
Name:TAM, CHRISTINE (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:TAM
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:LOH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5 MONTROSE DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1098
Mailing Address - Country:US
Mailing Address - Phone:914-980-4740
Mailing Address - Fax:
Practice Address - Street 1:PEARLE VISION
Practice Address - Street 2:1615 NORTHERN BLVD, #405
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030
Practice Address - Country:US
Practice Address - Phone:516-365-3843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008474152W00000X
NYTUV008474152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist