Juanita O Lao MD PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

115220 Issued in NY

Legal business name

JUANITA O LAO MD PC

Practice address

333 Lafayette Ave
Suite PB
Brooklyn, NY 11238-1350

Phone

(718) 789-1116

NPI assigned

Apr 28, 2011

Organization subpart

Yes

Parent organization

JUANITA O LAO MD PCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Juanita Ong Lao, MDNPI 1760568943

Title

Direct Owner

Phone

(718) 789-1116

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Part of

Juanita O Lao MD PC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Juanita Ong Lao, MD

  • Pediatrics Physician
  • Brooklyn, NY
  • NPI 1760568943
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1144511908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 DE KALB AVE.",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015425",
            "telephone_number": "718-789-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 LAFAYETTE AVE",
            "address_2": "SUITE PB",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112381350",
            "telephone_number": "718-789-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUANITA O LAO MD PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JUANITA O LAO MD PC",
        "enumeration_date": "2011-04-28",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "LAO",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_middle_name": "ONG",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "718-789-1116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "115220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00211918",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.