Provider Demographics
NPI:1417281247
Name:HOVANASIAN, CHARLENE (ACUPUNCTURIST)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:
Last Name:HOVANASIAN
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 412
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01936-0412
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28 BAY RD
Practice Address - Street 2:
Practice Address - City:SOUTH HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982-2202
Practice Address - Country:US
Practice Address - Phone:978-468-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-26
Last Update Date:2009-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MANOT YET171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist