Provider Demographics
NPI:1366767576
Name:LAU, KING L (RPH)
Entity type:Individual
Prefix:
First Name:KING
Middle Name:L
Last Name:LAU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:HENRY KING
Other - Middle Name:L
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:7901 BROADWAY
Mailing Address - Street 2:ELMHURST HOSPITAL PHARMACY DEPARTMENT
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1329
Mailing Address - Country:US
Mailing Address - Phone:718-334-2451
Mailing Address - Fax:718-334-8712
Practice Address - Street 1:7901 BROADWAY
Practice Address - Street 2:ELMHURST HOSPITAL PHARMACY DEPARTMENT
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-2451
Practice Address - Fax:718-334-8712
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034574183500000X
FLPS20991183500000X
NJ28RI01502900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist