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General NPI Number Information
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NPI Number | 1265086664
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Entity Type | Organization
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Legal Business Name | LU HOMECARE REHABILITATION SERVICE LLC
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Dates
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Enumeration Date | 07/24/2019
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | 236 FERRY ST
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City | NEWARK
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State | NJ
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Zip | 07105-5401
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Country | US
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Telephone | 973-589-7772
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Fax | 973-589-8228
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Provider Business Mailing Address
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Address Line | 206 MOUNTAIN VIEW TER
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City | BRANCHBURG
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State | NJ
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Zip | 08853-4193
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Country | US
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Telephone | 732-404-7160
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. KHANH CONG LU
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Credential | PT
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Telephone | 732-404-7160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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