Basic Information
| Provider Information | |||||||||
| NPI: | 1659479525 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YAU | ||||||||
| FirstName: | KIN | ||||||||
| MiddleName: | LUI | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 KURT DRIVE, | ||||||||
| Address2: | |||||||||
| City: | FLANDERS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739270286 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 151 KNOLLCROFT RD. | ||||||||
| Address2: | VA HEALTH CARE SYSTEM | ||||||||
| City: | LYONS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078395001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9086470180 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 146D00000X | 25MA03178600 | NJ | Y | Emergency Medical Service Providers | Personal Emergency Response Attendant |
ID Information
| ID | Type | State | Issuer | Description | BY8643240 | 01 | DEA NUMBER | OTHER |