Provider Demographics
NPI:1568831980
Name:LAO, JIAN
Entity Type:Individual
Prefix:MR
First Name:JIAN
Middle Name:
Last Name:LAO
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:KEN
Other - Middle Name:
Other - Last Name:LAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5 SERINA DR
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-1400
Mailing Address - Country:US
Mailing Address - Phone:609-297-7238
Mailing Address - Fax:
Practice Address - Street 1:5 SERINA DR
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-1400
Practice Address - Country:US
Practice Address - Phone:609-297-7238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00122200171100000X
PAAK001166171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist