Provider Demographics
NPI:1053923110
Name:TU, WENDY (MD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:TU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:XIAOMENG
Other - Middle Name:
Other - Last Name:TU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:75 FRANCIS STREET
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-732-6304
Mailing Address - Fax:617-732-6317
Practice Address - Street 1:75 FRANCIS STREET
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-732-6304
Practice Address - Fax:617-732-6317
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2021-06-18
Deactivation Date:2021-05-28
Deactivation Code:
Reactivation Date:2021-06-18
Provider Licenses
StateLicense IDTaxonomies
MA2834302085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology