MEDICARE: MR. REGINALD LAO TIU P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	024790-1	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00659537	OTHER	NY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023105921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. REGINALD LAO TIU P.T.

Provider Business Mailing Address
First Line	:	3310 QUEENS BLVD
Second Line	:	SUITE 301
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-2302
Country	:	US
Telephone Number	:	800-905-0513
Fax Number	:	347-536-3955

Provider Business Practice Location Address
First Line	:	3310 QUEENS BLVD
Second Line	:	SUITE 301
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-2302
Country	:	US
Telephone Number	:	800-905-0513
Fax Number	:	347-536-3955

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	05/26/2013

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