Healthcare Provider Details

I. General information

NPI: 1912560319
Provider Name (Legal Business Name): LUCY ZHU OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2019
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 BROADWAY
BROOKLYN NY
11206-5383
US

IV. Provider business mailing address

760 BROADWAY
BROOKLYN NY
11206-5317
US

V. Phone/Fax

Practice location:
  • Phone: 718-963-8000
  • Fax:
Mailing address:
  • Phone: 718-963-8603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV009029
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: