Healthcare Provider Details

I. General information

NPI: 1407799752
Provider Name (Legal Business Name): ZE YANG FU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CENTRAL AVE
LYNN MA
01901-1201
US

IV. Provider business mailing address

20 CENTRAL AVE
LYNN MA
01901-1201
US

V. Phone/Fax

Practice location:
  • Phone: 781-595-1350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT8402
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: