Provider Demographics
NPI:1073952313
Name:LUR, SHIH-YU (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:SHIH-YU
Middle Name:
Last Name:LUR
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 4TH AVE APT 6P
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4886
Mailing Address - Country:US
Mailing Address - Phone:617-335-0407
Mailing Address - Fax:
Practice Address - Street 1:263 7TH AVE STE 2A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3693
Practice Address - Country:US
Practice Address - Phone:718-246-8645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017983225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist