Provider Demographics
NPI:1316170087
Name:KWAN, LAI YEE
Entity type:Individual
Prefix:MRS
First Name:LAI
Middle Name:YEE
Last Name:KWAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-3487
Mailing Address - Country:US
Mailing Address - Phone:212-388-9886
Mailing Address - Fax:212-388-1228
Practice Address - Street 1:78 CLINTON ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-3487
Practice Address - Country:US
Practice Address - Phone:212-388-9886
Practice Address - Fax:212-388-1228
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041822183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist