Provider Demographics
NPI:1124527437
Name:SHU, LEE-YEN (PHYSICIAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:LEE-YEN
Middle Name:
Last Name:SHU
Suffix:
Gender:F
Credentials:PHYSICIAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 PLAINSBORO ROAD
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536
Mailing Address - Country:US
Mailing Address - Phone:732-822-9293
Mailing Address - Fax:609-750-1650
Practice Address - Street 1:408 PLAINSBORO ROAD
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536
Practice Address - Country:US
Practice Address - Phone:732-822-9293
Practice Address - Fax:609-750-1650
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00382900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty