Provider Demographics
NPI:1992876668
Name:TAM, HEI YAN (OD)
Entity type:Individual
Prefix:DR
First Name:HEI YAN
Middle Name:
Last Name:TAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1747 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1020
Mailing Address - Country:US
Mailing Address - Phone:347-713-8853
Mailing Address - Fax:
Practice Address - Street 1:6002 8TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4338
Practice Address - Country:US
Practice Address - Phone:718-439-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006957152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02733782Medicaid
NYC430B1Medicare PIN
NYV07789Medicare UPIN