Provider Demographics
NPI:1225470222
Name:LU, MENGDI (MD)
Entity Type:Individual
Prefix:
First Name:MENGDI
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:275 CAMBRIDGE ST FL 5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-3108
Mailing Address - Country:US
Mailing Address - Phone:617-726-8707
Mailing Address - Fax:617-724-2803
Practice Address - Street 1:275 CAMBRIDGE ST FL 5
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3108
Practice Address - Country:US
Practice Address - Phone:617-726-8707
Practice Address - Fax:617-724-2803
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAPENDING2080P0214X
MA268606208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics