Provider Demographics
NPI:1568530301
Name:CHEN, RUN S (LIC AC)
Entity Type:Individual
Prefix:
First Name:RUN
Middle Name:S
Last Name:CHEN
Suffix:
Gender:M
Credentials: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:CHINESE ACUPUNCTURE CENTER
Mailing Address - Street 2:8 WINTER STREET - #801
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108
Mailing Address - Country:US
Mailing Address - Phone:617-350-7721
Mailing Address - Fax:
Practice Address - Street 1:CHINESE ACUPUNCTURE CENTER
Practice Address - Street 2:8 WINTER STREET - #801
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108
Practice Address - Country:US
Practice Address - Phone:617-350-7721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist