Provider Demographics
NPI:1083739742
Name:LAI, WAI LING (MD)
Entity Type:Individual
Prefix:
First Name:WAI LING
Middle Name:
Last Name:LAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 COURT HOUSE SOUTH DENNIS ROAD
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-1968
Mailing Address - Country:US
Mailing Address - Phone:609-465-9333
Mailing Address - Fax:609-465-9333
Practice Address - Street 1:209 COURT HOUSE SOUTH DENNIS ROAD
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1968
Practice Address - Country:US
Practice Address - Phone:609-465-9333
Practice Address - Fax:609-465-9333
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04151700208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3275400Medicaid
NJJ0330OtherHORIZON BCBS