Provider Demographics
NPI:1295016707
Name:LU, FANG-I (MD)
Entity Type:Individual
Prefix:MS
First Name:FANG-I
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17N - 504 EAST 63RD STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7920
Mailing Address - Country:US
Mailing Address - Phone:412-626-4571
Mailing Address - Fax:
Practice Address - Street 1:504 E 63RD ST
Practice Address - Street 2:APT. 17N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7919
Practice Address - Country:US
Practice Address - Phone:412-626-4571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP80608207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology