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General NPI Number Information
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NPI Number | 1881779239
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Entity Type | Individual
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Provider Name | SUSAN C LAI RN NP
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1400 PELHAM PARKWAY BLDG 5 RM 312 JACOBI MEDICAL CENTER
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City | BRONX
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State | NY
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Zip | 10461
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Country | US
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Telephone | 718-918-6021
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Fax | 718-918-7701
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Provider Business Mailing Address
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Address Line | 20910 23RD AVENUE BH
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City | BAYSIDE
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State | NY
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Zip | 11360-1839
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Country | US
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Telephone | 718-423-1915
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Fax | 718-918-7701
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F3006071
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License Number State | NY
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