Provider Demographics
NPI:1497971204
Name:DAMJIGUEND, ROBIN ANNE (MAOM,LIC AC)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:ANNE
Last Name:DAMJIGUEND
Suffix:
Gender:F
Credentials:MAOM,LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 DIMICK ST
Mailing Address - Street 2:APT.1
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-4349
Mailing Address - Country:US
Mailing Address - Phone:617-504-3862
Mailing Address - Fax:
Practice Address - Street 1:34 BATTERYMARCH ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-3202
Practice Address - Country:US
Practice Address - Phone:617-451-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219524171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist