Provider Demographics
NPI:1326359134
Name:LAU, ANNA LOUISE (ARNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LOUISE
Last Name:LAU
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 DORSET DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-1947
Mailing Address - Country:US
Mailing Address - Phone:716-479-9858
Mailing Address - Fax:
Practice Address - Street 1:138 DORSET DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14223-1947
Practice Address - Country:US
Practice Address - Phone:716-479-9858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60156580363LW0102X
WAAP60186286363LW0102X
NY421118363LW0102X
NYF404800-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health