MEDICARE: MS. SU LUO M.D.

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207ND0101X	MOHS-Micrographic Surgery Physician	266195	MA
3	207N00000X	Dermatology Physician	MD15425	RI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	207N00000X	OTHER	MA	MEDICARE 855O

General Provider Information

NPI Number	:	1609165315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SU LUO M.D.

Provider Business Mailing Address
First Line	:	19 BELLE ISLE WAY
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02921-3542
Country	:	US
Telephone Number	:	401-527-5207
Fax Number	:

Provider Business Practice Location Address
First Line	:	67 S BEDFORD ST
Second Line	:
City	:	BURLINGTON
State	:	MA
Zip	:	01803-5108
Country	:	US
Telephone Number	:	781-744-8000
Fax Number	:

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

Provider Enumeration Date	:	04/04/2011
Last Update Date	:	10/05/2020

Similar Medicare Providers

1609453653 — ANNE Y NING MD
Practice Location Address:

67 S BEDFORD ST STE 101
BURLINGTON, MA
01803-5108

Practice Phone: 781-744-8000
Practice Fax:

1861238974 — MRS. MELANIE MARIE CRONIN RN
Practice Location Address:

67 S BEDFORD ST STE 202
BURLINGTON, MA
01803-5108

Practice Phone: 781-744-7000
Practice Fax:

1740363159 — DR. SHEILAJANE CINCOTTA DNP
Practice Location Address:

67 S BEDFORD ST
BURLINGTON, MA
01803-5108

Practice Phone: 617-865-9445
Practice Fax: 617-604-2293

1881848208 — MR. GREGORY CURTIS LICSW
Practice Location Address:

67 S BEDFORD ST , SUITE 400 WEST
BURLINGTON, MA
01803-5108

Practice Phone: 781-229-5874
Practice Fax: 781-272-0558

1326274200 — DR. JEFFREY BAUER TIGER M.D.
Practice Location Address:

67 S. BEDFORD STREET , LAHEY HOSPITAL AND MEDICAL CENTER
BURLINGTON, MA
01803-5108

Practice Phone: 781-744-5115
Practice Fax: 781-744-5687

1164710547 — MAURICE COUGHLAN ACNP
Practice Location Address:

67 S BEDFORD ST
BURLINGTON, MA
01803-5108

Practice Phone: 781-744-8000
Practice Fax:

Directions to “ MS. SU LUO M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.