Provider Demographics
NPI:1568857548
Name:LAW, LILLIAN (AUD)
Entity Type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:
Last Name:LAW
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13347 SANFORD AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5816
Mailing Address - Country:US
Mailing Address - Phone:718-461-9777
Mailing Address - Fax:718-461-4395
Practice Address - Street 1:13620 38TH AVE STE 7J
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4232
Practice Address - Country:US
Practice Address - Phone:718-670-0006
Practice Address - Fax:718-701-5883
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000042390237600000X
NY002536-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter