Provider Demographics
NPI:1063702405
Name:KAU, DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:KAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 LANSING ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-1983
Mailing Address - Country:US
Mailing Address - Phone:315-567-0390
Mailing Address - Fax:315-567-0333
Practice Address - Street 1:77 NELSON STREET, SUITE 240
Practice Address - Street 2:AMMS NEPHROLOGY
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1302
Practice Address - Country:US
Practice Address - Phone:315-567-0390
Practice Address - Fax:315-702-8393
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288997207R00000X, 207RN0300X
NJK08641568301841390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04778272Medicaid