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Organization

GREAT LAKES OTOLARYNGOLOGY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL C. LAI MD (PRESIDENT)
(716) 372-7205
Entity
Organization

Contact information

Practice address
2223 W STATE ST, SUITE 102, OLEAN, NY 14760-1938
(716) 692-3302
(716) 692-4342
Mailing address
2223 W STATE ST, SUITE 102, OLEAN, NY 14760-1938
(716) 692-3302
(716) 692-4342

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02079463
NY
Enumeration date
06/20/2006
Last updated
06/26/2008
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