Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 25MD00340000 | NJ |
N | 213EP1101X | Primary Podiatric Medicine | SC006401 | PA |
N | 213ES0103X | Foot & Ankle Surgery | SC006401 | PA |
NPI | 1023372653 |
---|---|
Provider Name | Dr. Alicia Lai |
First Address | Linwood, NJ 08221-1281 |
Second Address | Linwood, NJ 08221-1281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2012 |
Last Update Date | 02/06/2021 |