Provider Demographics
NPI:1144483116
Name:LU, REBECCA Y (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:Y
Last Name:LU
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7 MOUNT BETHEL RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-2636
Mailing Address - Country:US
Mailing Address - Phone:908-787-8088
Mailing Address - Fax:908-368-8648
Practice Address - Street 1:7 MOUNT BETHEL RD
Practice Address - Street 2:SUITE C
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-2636
Practice Address - Country:US
Practice Address - Phone:908-787-8088
Practice Address - Fax:908-368-8648
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2015-12-03
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Provider Licenses
StateLicense IDTaxonomies
NY246835207N00000X
NJ25MA08557200207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ171833MAGMedicare PIN