Provider Demographics
NPI:1528366069
Name:LAI, MAX SZI-WEI
Entity Type:Individual
Prefix:
First Name:MAX
Middle Name:SZI-WEI
Last Name:LAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 OLD COURTHOUSE RD STE 410
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3848
Mailing Address - Country:US
Mailing Address - Phone:703-734-2889
Mailing Address - Fax:703-734-2139
Practice Address - Street 1:8320 OLD COURTHOUSE RD STE 410
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3848
Practice Address - Country:US
Practice Address - Phone:703-734-2889
Practice Address - Fax:703-734-2139
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-08
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033464225100000X
VA2305214472225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist