Provider Demographics
NPI:1437660099
Name:LU, RICHARD ALBERT (OTD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALBERT
Last Name:LU
Suffix:
Gender:M
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 MANETTE CT
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2613
Mailing Address - Country:US
Mailing Address - Phone:484-318-9594
Mailing Address - Fax:
Practice Address - Street 1:11140 ROCKVILLE PIKE STE 303
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3148
Practice Address - Country:US
Practice Address - Phone:301-231-7138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-22
Last Update Date:2017-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08239225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist