Healthcare Provider Details

I. General information

NPI: 1023345618
Provider Name (Legal Business Name): YU JEN LAI, MD.,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

830 PARK AVE
HUNTINGTON NY
11743-4543
US

IV. Provider business mailing address

14 HARMONY LN
SETAUKET NY
11733-3814
US

V. Phone/Fax

Practice location:
  • Phone: 631-271-5800
  • Fax: 613-271-5807
Mailing address:
  • Phone: 631-689-3960
  • Fax: 631-689-3960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. YU JEN LAI
Title or Position: OWNER
Credential: MD
Phone: 631-689-3960