Provider Demographics
NPI:1487197331
Name:UY, LORENZO LUIS (PT)
Entity Type:Individual
Prefix:
First Name:LORENZO LUIS
Middle Name:
Last Name:UY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 MARLBORO RD
Mailing Address - Street 2:
Mailing Address - City:WOOD RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07075-1226
Mailing Address - Country:US
Mailing Address - Phone:347-720-9301
Mailing Address - Fax:
Practice Address - Street 1:477 MARLBORO RD
Practice Address - Street 2:
Practice Address - City:WOOD RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07075-1226
Practice Address - Country:US
Practice Address - Phone:347-720-9301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-27
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01705200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist