MEDICARE: PAULINE LAU

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	183500000X	Pharmacist	066790	NY

General Provider Information

NPI Number	:	1619570124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULINE LAU

Provider Business Mailing Address
First Line	:	218 MYRTLE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-3934
Country	:	US
Telephone Number	:	646-240-5601
Fax Number	:

Provider Business Practice Location Address
First Line	:	6831 BAY PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-5507
Country	:	US
Telephone Number	:	718-837-1471
Fax Number	:

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

Provider Enumeration Date	:	11/17/2020
Last Update Date	:	06/22/2021

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Directions to “ PAULINE LAU ” Practice Location

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