MEDICARE: MRS. RUNJIE YU PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	5502003883	MI

General Provider Information

NPI Number	:	1477442200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RUNJIE YU PTA

Provider Business Mailing Address
First Line	:	5844 STRAWBERRY CIR
Second Line	:
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-5506
Country	:	US
Telephone Number	:	734-306-8093
Fax Number	:

Provider Business Practice Location Address
First Line	:	3310 W COMMERCE RD
Second Line	:
City	:	MILFORD
State	:	MI
Zip	:	48380-3100
Country	:	US
Telephone Number	:	248-685-1400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2025
Last Update Date	:	06/27/2025

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