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General NPI Number Information
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NPI Number | 1518246883
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Entity Type | Individual
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Provider Name | YAN LU O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 380 PLEASANT ST STE 16
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City | MALDEN
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State | MA
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Zip | 02148-8123
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Country | US
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Telephone | 781-870-0523
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Fax | 781-775-3451
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Provider Business Mailing Address
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Address Line | 380 PLEASANT ST STE 16
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City | MALDEN
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State | MA
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Zip | 02148-8123
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Country | US
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Telephone | 781-870-0523
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Fax | 781-775-3451
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4872
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License Number State | MA
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