Provider Demographics
NPI:1235833146
Name:RAYMOND LAU FAMILY MEDICINE PC
Entity Type:Organization
Organization Name:RAYMOND LAU FAMILY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:646-808-4471
Mailing Address - Street 1:384 COUNTY ROAD 513
Mailing Address - Street 2:
Mailing Address - City:CALIFON
Mailing Address - State:NJ
Mailing Address - Zip Code:07830-4158
Mailing Address - Country:US
Mailing Address - Phone:646-808-4471
Mailing Address - Fax:
Practice Address - Street 1:89 BOWERY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4915
Practice Address - Country:US
Practice Address - Phone:646-808-4471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty