Provider Demographics
NPI:1649506387
Name:LAU, CECILIA Y (RN, MS, APRN)
Entity type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:Y
Last Name:LAU
Suffix:
Gender:F
Credentials:RN, MS, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 S FREDERICK AVE,
Mailing Address - Street 2:SUITE 213
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1282
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:604 S FREDERICK AVE,
Practice Address - Street 2:SUITE 213
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1282
Practice Address - Country:US
Practice Address - Phone:240-489-7448
Practice Address - Fax:301-355-6614
Is Sole Proprietor?:No
Enumeration Date:2009-10-31
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR059883364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult