Provider Demographics
NPI:1003094061
Name:KAI WING WAI, O.D., PLLC
Entity Type:Organization
Organization Name:KAI WING WAI, O.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAI
Authorized Official - Middle Name:WING
Authorized Official - Last Name:WAI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-559-0088
Mailing Address - Street 1:13620 38TH AVE
Mailing Address - Street 2:STE 5B
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4233
Mailing Address - Country:US
Mailing Address - Phone:718-559-0088
Mailing Address - Fax:
Practice Address - Street 1:13620 38TH AVE
Practice Address - Street 2:STE 5B
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4233
Practice Address - Country:US
Practice Address - Phone:718-559-0088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004350261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1003094061Medicare PIN
09552Medicare PIN