Healthcare Provider Details

I. General information

NPI: 1851196331
Provider Name (Legal Business Name): MS. YAQI LU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 SOUTH ST
BOSTON MA
02111-2826
US

IV. Provider business mailing address

145 SOUTH ST
BOSTON MA
02111-2826
US

V. Phone/Fax

Practice location:
  • Phone: 617-521-6730
  • Fax: 617-457-6600
Mailing address:
  • Phone: 617-521-6730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2390848
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2390848
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: