Provider Demographics
NPI:1508848441
Name:LAU, CHEUK WAI (MD)
Entity Type:Individual
Prefix:DR
First Name:CHEUK
Middle Name:WAI
Last Name:LAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MOTT ST
Mailing Address - Street 2:ROOM 204
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 STREET
Practice Address - Street 2:ROOM 204
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013
Practice Address - Country:US
Practice Address - Phone:212-226-6002
Practice Address - Fax:212-226-6004
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY038101183500000X
NY217818208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI130701OtherMEIDCARE
NY02092340Medicaid
NY02092340Medicaid
NY1B0701Medicare ID - Type Unspecified