MEDICARE: SERENA LU

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	152W00000X	Optometrist	011201	NY

General Provider Information

NPI Number	:	1851285365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERENA LU

Provider Business Mailing Address
First Line	:	4536 215TH PL
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-3445
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	632 FLATBUSH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-5606
Country	:	US
Telephone Number	:	718-766-0217
Fax Number	:

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

Provider Enumeration Date	:	06/07/2025
Last Update Date	:	08/05/2025

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Directions to “ SERENA LU ” Practice Location

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