MEDICARE: DR. YAN LU O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	4872	MA

General Provider Information

NPI Number	:	1518246883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YAN LU O.D.

Provider Business Mailing Address
First Line	:	380 PLEASANT ST STE 16
Second Line	:
City	:	MALDEN
State	:	MA
Zip	:	02148-8123
Country	:	US
Telephone Number	:	781-870-0523
Fax Number	:	781-755-3451

Provider Business Practice Location Address
First Line	:	380 PLEASANT ST STE 16
Second Line	:
City	:	MALDEN
State	:	MA
Zip	:	02148-8123
Country	:	US
Telephone Number	:	781-870-0523
Fax Number	:	781-775-3451

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2011
Last Update Date	:	03/23/2026

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Directions to “ DR. YAN LU O.D.” Practice Location

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