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General NPI Number Information
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NPI Number | 1689806226
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Entity Type | Individual
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Provider Name | CORINNA MARIE LAU DPT
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Gender | Female
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Dates
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Enumeration Date | 08/16/2009
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 91 COUNTRY CLUB DR
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-4535
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Country | US
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Telephone | 516-808-7024
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Fax |
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Provider Business Mailing Address
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Address Line | 91 COUNTRY CLUB DR
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-4535
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Country | US
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Telephone | 516-808-7024
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 031572
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License Number State | NY
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