Provider Demographics
NPI:1316024433
Name:WEINSTEIN, KERRY (MA, LIC ACUP)
Entity Type:Individual
Prefix:MR
First Name:KERRY
Middle Name:
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:MA, LIC ACUP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-1371
Mailing Address - Country:US
Mailing Address - Phone:978-443-6789
Mailing Address - Fax:978-440-8339
Practice Address - Street 1:75 UNION AVE STE 101
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-2255
Practice Address - Country:US
Practice Address - Phone:978-443-6789
Practice Address - Fax:978-440-8339
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA058171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist