Organization
FREDERICK LU MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK LU MD (OWNER)
(908) 527-9863
Entity
Organization
Contact information
Practice address
1156 LIBERTY AVE, HILLSIDE, NJ 07205
(908) 527-9863
Mailing address
1156 LIBERTY AVE, HILLSIDE, NJ 07205
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
25MA01980300
—
208VP0000X
Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2467704
—
NJ
01
—
550847
AETNA
—
Enumeration date
07/21/2008
Last updated
10/22/2008
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