Active NPI
Roderick Agonoy Lu, PT
- Physical Therapist
- Kendall Park, NJ
National Provider Identifier
1679917215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTQAOOO7498
- Practice address
- 23 Greyhound CT
Kendall Park, NJ 08824-1492 - Phone
- (732) 599-9310
- NPI assigned
- Apr 25, 2013
- Last updated
- Mar 20, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTQAOOO7498 | NJ | Primary |
Addresses
Primary practice location
23 Greyhound CT
Kendall Park, NJ 08824-1492
Mailing address
23 Greyhound CT
Kendall Park, NJ 08824-1492
Phone (732) 599-9310
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTQAOOO7498 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roderick Lu PT LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Kendall Park, NJ
- NPI 1134544752
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395273600000",
"number": "1679917215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 GREYHOUND CT",
"city": "KENDALL PARK",
"state": "NJ",
"postal_code": "088241492",
"telephone_number": "732-599-9310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 GREYHOUND CT",
"city": "KENDALL PARK",
"state": "NJ",
"postal_code": "088241492",
"telephone_number": "732-599-9310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGONOY LU",
"first_name": "RODERICK",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-25",
"last_updated": "2014-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "PTQAOOO7498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kendall Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.