Healthcare Provider Details

I. General information

NPI: 1972465763
Provider Name (Legal Business Name): ZHAOYU LU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11721 KEMP MILL RD
SILVER SPRING MD
20902-1722
US

IV. Provider business mailing address

7902 TYSONS ONE PL UNIT 513
MC LEAN VA
22102-5219
US

V. Phone/Fax

Practice location:
  • Phone: 571-238-0954
  • Fax:
Mailing address:
  • Phone: 571-238-0954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number11578
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: