Provider Demographics
NPI:1730477274
Name:CHEUK W.LAU M.D.,P.C.
Entity Type:Organization
Organization Name:CHEUK W.LAU M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHEUK
Authorized Official - Middle Name:WAI
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-226-6002
Mailing Address - Street 1:2 MOTT ST RM 204
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5003
Mailing Address - Country:US
Mailing Address - Phone:212-226-6002
Mailing Address - Fax:212-226-6004
Practice Address - Street 1:2 MOTT ST RM 204
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5003
Practice Address - Country:US
Practice Address - Phone:212-226-6002
Practice Address - Fax:212-226-6004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217818208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02092340Medicaid
NY1B0701Medicare UPIN