Provider Demographics
NPI:1295383933
Name:LAU, SYDNEY ALEXANDRA (MS, CGC)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:ALEXANDRA
Last Name:LAU
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E 46TH ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-2610
Mailing Address - Country:US
Mailing Address - Phone:914-410-1316
Mailing Address - Fax:
Practice Address - Street 1:3611 14TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3787
Practice Address - Country:US
Practice Address - Phone:718-851-5773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS