MEDICARE: MR. ANDREW LAI AGPCNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	F309391	NY

General Provider Information

NPI Number	:	1023650850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW LAI AGPCNP-BC

Provider Business Mailing Address
First Line	:	2736 INDEPENDENCE AVE APT 5G
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-4655
Country	:	US
Telephone Number	:	917-518-9688
Fax Number	:

Provider Business Practice Location Address
First Line	:	2736 INDEPENDENCE AVE APT 5G
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-4655
Country	:	US
Telephone Number	:	917-518-9688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2019
Last Update Date	:	10/14/2019

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