Provider Demographics
NPI:1205004645
Name:HARTSTEIN, RACHEL A (LIC AC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:HARTSTEIN
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 1:189 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1382
Mailing Address - Country:US
Mailing Address - Phone:781-860-8808
Mailing Address - Fax:
Practice Address - Street 1:SAGE COMMUNITY ACUPUNCTURE
Practice Address - Street 2:62 MASSACHUSETTS AVENUE
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420
Practice Address - Country:US
Practice Address - Phone:781-860-8808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA671171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist