Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 268606 | MA |
Y | 2080P0214X | Pediatric Pulmonologist | PENDING | MA |
NPI | 1225470222 |
---|---|
Provider Name | Mengdi Lu |
First Address | Boston, MA 02114-3108 |
Second Address | Boston, MA 02114-3108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2013 |
Last Update Date | 10/09/2019 |