Healthcare Provider Details

I. General information

NPI: 1902788086
Provider Name (Legal Business Name): LILY ZHU
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 07/22/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 WASHINGTON ST
WELLESLEY MA
02481-1752
US

IV. Provider business mailing address

30 LONGFELLOW RD
NEWTON MA
02462-1506
US

V. Phone/Fax

Practice location:
  • Phone: 781-263-7234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH1001724
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: