Provider Demographics
NPI:1528384898
Name:ACCARDI, AMY JO (LAC)
Entity Type:Individual
Prefix:
First Name:AMY JO
Middle Name:
Last Name:ACCARDI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BEACON ST
Mailing Address - Street 2:SUITE 520
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-3017
Mailing Address - Country:US
Mailing Address - Phone:617-275-3488
Mailing Address - Fax:
Practice Address - Street 1:11 BEACON ST
Practice Address - Street 2:SUITE 520
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-3017
Practice Address - Country:US
Practice Address - Phone:617-275-3488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251245171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist