Provider Demographics
NPI:1013196419
Name:VAFIDES, CAROL J (LIC AC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:J
Last Name:VAFIDES
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 REVERE ST
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-2511
Mailing Address - Country:US
Mailing Address - Phone:781-878-9998
Mailing Address - Fax:
Practice Address - Street 1:164 WASHINGTON STREET #105
Practice Address - Street 2:CAROL VAFIDES ACUPUNCTURE
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061
Practice Address - Country:US
Practice Address - Phone:781-878-9998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA452171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist