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NPI Code Detail

MEDICARE: KEITH LAU

MEDICARE: KEITH 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
1183500000XPharmacist057744NY

General Provider Information

NPI Number : 1710325212
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH LAU
Provider Business Mailing Address
First Line : 528 ROCKAWAY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-5617
Country : US
Telephone Number : 718-342-3446
Fax Number :
Provider Business Practice Location Address
First Line : 582 ROCKAWAY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-5625
Country : US
Telephone Number : 917-660-2894
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2013
Last Update Date : 08/13/2013

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Directions to “ KEITH LAU ” Practice Location

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