Provider Demographics
NPI:1023372653
Name:LAI, ALICIA (DPM)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:LAI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 NEW RD STE 205
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1281
Mailing Address - Country:US
Mailing Address - Phone:609-653-2066
Mailing Address - Fax:
Practice Address - Street 1:222 NEW RD STE 205
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1281
Practice Address - Country:US
Practice Address - Phone:609-653-2066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006401213EP1101X, 213ES0103X
NJ25MD00340000213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery