Provider Demographics
NPI:1902171960
Name:LAI, ELYSE K (RN)
Entity type:Individual
Prefix:MS
First Name:ELYSE
Middle Name:K
Last Name:LAI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 BAXTER ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3604
Mailing Address - Country:US
Mailing Address - Phone:212-226-8072
Mailing Address - Fax:
Practice Address - Street 1:143 BAXTER ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3604
Practice Address - Country:US
Practice Address - Phone:212-226-8072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare