Provider Demographics
NPI:1376941294
Name:WILSON C. CHAU PHYSICIAN, PLLC
Entity Type:Organization
Organization Name:WILSON C. CHAU PHYSICIAN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILSON
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-661-3100
Mailing Address - Street 1:4231 COLDEN STREET 109
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3982
Mailing Address - Country:US
Mailing Address - Phone:718-661-3100
Mailing Address - Fax:718-661-2730
Practice Address - Street 1:4231 COLDEN STREET 109
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3982
Practice Address - Country:US
Practice Address - Phone:718-661-3100
Practice Address - Fax:718-661-2730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196506208200000X, 2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Multi-Specialty