Provider Demographics
NPI:1679928691
Name:LAU, ANTHONY CHI-WING (MD, PHD, FRCSC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:CHI-WING
Last Name:LAU
Suffix:
Gender:M
Credentials:MD, PHD, FRCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 PULASKI RD STE 262
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-1602
Mailing Address - Country:US
Mailing Address - Phone:631-351-4840
Mailing Address - Fax:631-651-4263
Practice Address - Street 1:284 PULASKI RD STE 262
Practice Address - Street 2:
Practice Address - City:GREENLAWN
Practice Address - State:NY
Practice Address - Zip Code:11740-1602
Practice Address - Country:US
Practice Address - Phone:631-351-4840
Practice Address - Fax:631-651-4263
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2022-07-21
Deactivation Date:2016-12-21
Deactivation Code:
Reactivation Date:2017-03-09
Provider Licenses
StateLicense IDTaxonomies
FLTRN23220390200000X
390200000X
NY289326207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program