Provider Demographics
NPI:1659455889
Name:LAU, KUOK WAH (MD)
Entity Type:Individual
Prefix:DR
First Name:KUOK
Middle Name:WAH
Last Name:LAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:KUOK
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:575 UNDERHILL BLVD.
Mailing Address - Street 2:SUITE 179
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3417
Mailing Address - Country:US
Mailing Address - Phone:516-938-2877
Mailing Address - Fax:516-933-3838
Practice Address - Street 1:575 UNDERHILL BLVD.
Practice Address - Street 2:SUITE 179
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3417
Practice Address - Country:US
Practice Address - Phone:516-938-2877
Practice Address - Fax:516-933-3838
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162763207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY70F601Medicare ID - Type Unspecified
NYD46885Medicare UPIN