Provider Demographics
NPI:1720008980
Name:LU, LOUISE P (MD)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:P
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:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:60 HOSPITAL RD
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2205
Practice Address - Country:US
Practice Address - Phone:978-466-2931
Practice Address - Fax:978-466-2779
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59746207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3070956Medicaid
MA110049200AMedicaid
MA3070956Medicaid
MAE59659Medicare UPIN
MA110049200AMedicaid