Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F309391 | NY |
NPI | 1023650850 |
---|---|
Provider Name | Mr. Andrew Lai |
First Address | Bronx, NY 10463-4655 |
Second Address | Bronx, NY 10463-4655 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2019 |
Last Update Date | 14/10/2019 |