Provider Demographics
NPI:1134491848
Name:EASTWAY WELLNESS LLC
Entity Type:Organization
Organization Name:EASTWAY WELLNESS LLC
Other - Org Name:EASTWAY ACUPUNCTURE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YI
Authorized Official - Middle Name:
Authorized Official - Last Name:LUO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-688-0138
Mailing Address - Street 1:11 VANDERBILT AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-5056
Mailing Address - Country:US
Mailing Address - Phone:781-688-0138
Mailing Address - Fax:781-269-5613
Practice Address - Street 1:11 VANDERBILT AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5056
Practice Address - Country:US
Practice Address - Phone:781-688-0138
Practice Address - Fax:781-269-5613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1578721338OtherNPI