Basic Information
| Provider Information | |||||||||
| NPI: | 1467004556 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | YA-TSENG WILLIAM LU, M.D., PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6852 | ||||||||
| Address2: | |||||||||
| City: | BRIDGEWATER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088070852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162882718 | ||||||||
| FaxNumber: | 7328751265 | ||||||||
| Practice Location | |||||||||
| Address1: | 2015 FOREST AVE STE A3 | ||||||||
| Address2: | |||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103031736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188151000 | ||||||||
| FaxNumber: | 7188158122 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2019 | ||||||||
| LastUpdateDate: | 06/28/2020 | ||||||||
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| AuthorizedOfficialLastName: | LU | ||||||||
| AuthorizedOfficialFirstName: | YA-TSENG | ||||||||
| AuthorizedOfficialMiddleName: | WILLIAM | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7328036135 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 06/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.