Provider Demographics
NPI:1265419816
Name:LAI, YUEN SIM (PHARM D)
Entity type:Individual
Prefix:DR
First Name:YUEN
Middle Name:SIM
Last Name:LAI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 DEMING WAY APT 308
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1992
Mailing Address - Country:US
Mailing Address - Phone:414-241-5443
Mailing Address - Fax:
Practice Address - Street 1:80 1ST ST
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU SAC
Practice Address - State:WI
Practice Address - Zip Code:53578-1550
Practice Address - Country:US
Practice Address - Phone:608-643-7243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118420-0183500000X
WI13846-040183500000X
DC183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist