Provider Demographics
NPI:1447455589
Name:WAIHO LUM MD PLLC
Entity type:Organization
Organization Name:WAIHO LUM MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:WAIHO
Authorized Official - Middle Name:
Authorized Official - Last Name:LUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-734-6621
Mailing Address - Street 1:11201 75TH AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5633
Mailing Address - Country:US
Mailing Address - Phone:718-268-6808
Mailing Address - Fax:718-268-6858
Practice Address - Street 1:11201 75TH AVE
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5633
Practice Address - Country:US
Practice Address - Phone:718-268-6808
Practice Address - Fax:718-268-6858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202905261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care