Basic Information
| Provider Information | |||||||||
| NPI: | 1194952838 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YU | ||||||||
| FirstName: | YI-LO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 HOSPITAL DR STE 501 | ||||||||
| Address2: | |||||||||
| City: | HOLYOKE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010406606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135342826 | ||||||||
| FaxNumber: | 4135342829 | ||||||||
| Practice Location | |||||||||
| Address1: | 15 HOSPITAL DR STE 501 | ||||||||
| Address2: | |||||||||
| City: | HOLYOKE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010406606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135342826 | ||||||||
| FaxNumber: | 4135342829 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2009 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 256888 | MA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 110097222/A | 05 | MA | MEDICAID |