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NPI Code Detail

MEDICARE: DIAN LAU MD

MEDICARE: DIAN LAU MD
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
1207L00000XAnesthesiology PhysicianMD052887LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LA780285OTHERPAPA BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720085244
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIAN LAU MD
Provider Business Mailing Address
First Line : 520 S 19TH ST
Second Line : STE 1B
City : PHILADELPHIA
State : PA
Zip : 19146-1449
Country : US
Telephone Number : 215-545-4173
Fax Number : 215-545-1543
Provider Business Practice Location Address
First Line : 520 S 19TH ST
Second Line : STE 1B
City : PHILADELPHIA
State : PA
Zip : 19146-1449
Country : US
Telephone Number : 215-545-4173
Fax Number : 215-545-1543
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 09/09/2015

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1205833233 — DIANE MURRAY C.R.N.A.
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1013962331 — RITTENHOUSE ANESTHESIA ASSOCIATES, LTD.
Practice Location Address:
520 S 19TH ST
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Practice Fax: 215-545-1543

Directions to “ DIAN LAU MD” Practice Location

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