Provider Demographics
NPI:1023237112
Name:LAU, PETER KAM TAK (AP)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:KAM TAK
Last Name:LAU
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2841 W ABIACA CIR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-7135
Mailing Address - Country:US
Mailing Address - Phone:954-423-3511
Mailing Address - Fax:
Practice Address - Street 1:2841 W ABIACA CIR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-7135
Practice Address - Country:US
Practice Address - Phone:954-423-3511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2166171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist