Provider Demographics
NPI:1174650733
Name:HAMAZAKI, MASAYUKI (LIC AC)
Entity Type:Individual
Prefix:
First Name:MASAYUKI
Middle Name:
Last Name:HAMAZAKI
Suffix:
Gender:M
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:JAPANESE ACUPUNCTURE CLINIC
Mailing Address - Street 2:2 CENTRAL STREET - #201
Mailing Address - City:MIDDLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01949
Mailing Address - Country:US
Mailing Address - Phone:978-777-3833
Mailing Address - Fax:
Practice Address - Street 1:JAPANESE ACUPUNCTURE CLINIC
Practice Address - Street 2:2 CENTRAL STREET - #201
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949
Practice Address - Country:US
Practice Address - Phone:978-777-3833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA622171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist