Provider Demographics
NPI:1992065387
Name:LU, SAMUEL J (LPT)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:J
Last Name:LU
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1907 PARK AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5530
Mailing Address - Country:US
Mailing Address - Phone:908-561-2220
Mailing Address - Fax:908-769-5308
Practice Address - Street 1:1907 PARK AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5530
Practice Address - Country:US
Practice Address - Phone:908-561-2220
Practice Address - Fax:908-769-5308
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00822100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist