Provider Demographics
NPI:1659431815
Name:HUANG, YU (LIC AC, MAOM)
Entity Type:Individual
Prefix:
First Name:YU
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:LIC AC, MAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 HILL RD APT 406
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-4312
Mailing Address - Country:US
Mailing Address - Phone:617-359-7126
Mailing Address - Fax:617-484-1994
Practice Address - Street 1:16 CLARKE ST STE 16
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-4938
Practice Address - Country:US
Practice Address - Phone:617-359-7126
Practice Address - Fax:617-484-1994
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210999171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist