Healthcare Provider Details

I. General information

NPI: 1669059747
Provider Name (Legal Business Name): JAIME LAU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 N LAKEVIEW DR STE 202
GIBBSBORO NJ
08026-1026
US

IV. Provider business mailing address

63 N LAKEVIEW DR STE 202
GIBBSBORO NJ
08026-1026
US

V. Phone/Fax

Practice location:
  • Phone: 856-435-6000
  • Fax:
Mailing address:
  • Phone: 856-435-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA12327400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: