Provider Demographics
NPI:1760960769
Name:YU, BETTY (PMHNP-BC, FNP-BC)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:PMHNP-BC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 TURNPIKE ST STE 206
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2357
Mailing Address - Country:US
Mailing Address - Phone:781-996-0046
Mailing Address - Fax:617-250-8262
Practice Address - Street 1:275 TURNPIKE ST STE 206
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2357
Practice Address - Country:US
Practice Address - Phone:617-750-6642
Practice Address - Fax:617-250-8262
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2303520363LF0000X, 363LP0808X
NH085782-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily