Basic Information
Provider Information
NPI: 1508413832
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LUI
FirstName: ALLISON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11020 71ST AVE APT 722
Address2:  
City: FOREST HILLS
State: NY
PostalCode: 113754575
CountryCode: US
TelephoneNumber: 6462497394
FaxNumber:  
Practice Location
Address1: 2579 OCEAN AVE
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112294552
CountryCode: US
TelephoneNumber: 6467800926
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/21/2019
LastUpdateDate: 08/21/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X02379001NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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