Provider Demographics
NPI:1407206311
Name:PHYU, EI EI (MD)
Entity Type:Individual
Prefix:
First Name:EI EI
Middle Name:
Last Name:PHYU
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 1:4315 45TH ST APT 6B
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-2368
Mailing Address - Country:US
Mailing Address - Phone:347-832-9722
Mailing Address - Fax:
Practice Address - Street 1:260 COCHITUATE RD STE 101
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4608
Practice Address - Country:US
Practice Address - Phone:508-628-9660
Practice Address - Fax:508-628-9668
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA278281207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine