Provider Demographics
NPI:1093992687
Name:PANASJUK-PALIWODA, NATALIA L (LAC)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:L
Last Name:PANASJUK-PALIWODA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-5316
Mailing Address - Country:US
Mailing Address - Phone:781-848-1342
Mailing Address - Fax:
Practice Address - Street 1:399 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4717
Practice Address - Country:US
Practice Address - Phone:781-843-3006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223061171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist