Healthcare Provider Details

I. General information

NPI: 1932723673
Provider Name (Legal Business Name): ROSA LU YU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 ALBANY ST FL 6 SHAPIRO BLDG
BOSTON MA
02118-2335
US

IV. Provider business mailing address

85 E CONCORD ST FL 7
BOSTON MA
02118-2335
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-6525
  • Fax:
Mailing address:
  • Phone: 617-638-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number292521
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberETLL-1009
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: