Provider Demographics
NPI:1679843858
Name:CHU, SONYA J (MAOM, LMT)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:J
Last Name:CHU
Suffix:
Gender:F
Credentials:MAOM, LMT
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 97
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02471-0097
Mailing Address - Country:US
Mailing Address - Phone:617-767-2987
Mailing Address - Fax:
Practice Address - Street 1:180 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-8448
Practice Address - Country:US
Practice Address - Phone:617-767-2987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAIN PROCESS171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist