Provider Demographics
NPI:1245387455
Name:MENG, QIN (MACU)
Entity Type:Individual
Prefix:
First Name:QIN
Middle Name:
Last Name:MENG
Suffix:
Gender:F
Credentials:MACU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 WARWICK RD
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-1237
Mailing Address - Country:US
Mailing Address - Phone:617-877-4726
Mailing Address - Fax:
Practice Address - Street 1:2 SURVEY CIR # 2B
Practice Address - Street 2:
Practice Address - City:N BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01862-2136
Practice Address - Country:US
Practice Address - Phone:978-262-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208337171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist