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NPI Code Detail

MEDICARE: HENRY S, LAO MD PC

MEDICARE: HENRY S, LAO MD PC
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
1207R00000XInternal Medicine Physician120158NY

Other Identifiers

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

General Provider Information

NPI Number : 1558667527
Entity Type Code : Organization
Provider Name (Legal Business Name) : HENRY S, LAO MD PC
Provider Business Mailing Address
First Line : 1204 DITMAS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-6032
Country : US
Telephone Number : 718-941-2000
Fax Number : 718-284-9888
Provider Business Practice Location Address
First Line : 1204 DITMAS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-6032
Country : US
Telephone Number : 718-941-2000
Fax Number : 718-284-9888
Authorized Official
Title or Position : PRESIDENT
Name : DR. HENRY SY LAO
Credential : MD
Telephone Number : 718-941-2000
Provider Enumeration Date : 02/08/2011
Last Update Date : 02/08/2011

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