MEDICARE: DR. JENGYU LAI DPM

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	213E00000X	Podiatrist	635	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750383808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENGYU LAI DPM

Provider Business Mailing Address
First Line	:	3070 WELLNER DR NE
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55906-8427
Country	:	US
Telephone Number	:	507-218-3095
Fax Number	:	507-218-3097

Provider Business Practice Location Address
First Line	:	3070 WELLNER DR NE
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55906-8427
Country	:	US
Telephone Number	:	507-218-3095
Fax Number	:	507-218-3097

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	05/12/2011

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Directions to “ DR. JENGYU LAI DPM” Practice Location

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