Provider Demographics
NPI:1326621368
Name:LAU, ERIC KA CHUN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:KA CHUN
Last Name:LAU
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:83 NORMAN ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1339
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-3617
Practice Address - Fax:212-263-8640
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY026562363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical