MEDICARE: LARISSA LEE-LUM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	41YS00954700	NJ

General Provider Information

NPI Number	:	1053058453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARISSA LEE-LUM

Provider Business Mailing Address
First Line	:	1 BLACKHAWK CT
Second Line	:
City	:	PRINCETON JUNCTION
State	:	NJ
Zip	:	08550-3112
Country	:	US
Telephone Number	:	609-651-1117
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BLACKHAWK CT
Second Line	:
City	:	PRINCETON JUNCTION
State	:	NJ
Zip	:	08550-3112
Country	:	US
Telephone Number	:	609-651-1117
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2022
Last Update Date	:	05/17/2022

Similar Medicare Providers

1831225481 — THERAMEDX, LLC
Practice Location Address:

755 NORTH AVE STE B
GRAND JUNCTION, CO
81501-3112

Practice Phone: 886-461-5020
Practice Fax: 970-257-1880

1215120423 — CHIROPRACTIC AND ACUPUNCTURE CLINIC P.C.
Practice Location Address:

755 NORTH AVE , #D
GRAND JUNCTION, CO
81501-3112

Practice Phone: 970-241-2400
Practice Fax: 970-274-3786

1760095244 — DR. ALEXANDER KISS PSY.D.
Practice Location Address:

88 PRINCETON HIGHTSTOWN RD
PRINCETON JUNCTION, NJ
08550-1100

Practice Phone: 732-982-2888
Practice Fax:

1578392304 — ASHLEY URENA LAC
Practice Location Address:

231 CLARKSVILLE RD STE 4A
PRINCETON JUNCTION, NJ
08550-5300

Practice Phone: 732-982-2888
Practice Fax:

1174149041 — MAURISA D GAINER LPC
Practice Location Address:

231 CLARKSVILLE RD STE 4A
PRINCETON JUNCTION, NJ
08550-5300

Practice Phone: 732-982-2888
Practice Fax: 847-859-5885

1811419310 — SHOSHANNA J JOSS LCSW
Practice Location Address:

88 PRINCETON HIGHTSTOWN RD STE 202
PRINCETON JUNCTION, NJ
08550-1100

Practice Phone: 732-982-2888
Practice Fax:

Directions to “ LARISSA LEE-LUM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.