Healthcare Provider Details

I. General information

NPI: 1902856008
Provider Name (Legal Business Name): LEON LIANG-YU LAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW #2A38
WASHINGTON DC
20010-2976
US

IV. Provider business mailing address

110 IRVING ST NW #2A38
WASHINGTON DC
20010-2976
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-2848
  • Fax:
Mailing address:
  • Phone: 202-877-2848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD034727
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: