1962589465 NPI number — DR. HERBERT KWONG YEE LAU PHD LAC

Table of content: DR. HERBERT KWONG YEE LAU PHD LAC (NPI 1962589465)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962589465 NPI number — DR. HERBERT KWONG YEE LAU PHD LAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAU
Provider First Name:
HERBERT
Provider Middle Name:
KWONG YEE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD LAC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAU
Provider Other First Name:
HERBERT
Provider Other Middle Name:
K
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD LAC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1962589465
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5859 TRANSIT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST AMHERST
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14051-1885
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-688-1768
Provider Business Mailing Address Fax Number:
716-688-1768

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5859 TRANSIT ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST AMHERST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14051-1885
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-688-1768
Provider Business Practice Location Address Fax Number:
716-688-1768
Provider Enumeration Date:
11/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  001308 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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