Provider Demographics
NPI:1689341026
Name:EASTHAMPTON COMMUNITY ACUPUNCTURE
Entity Type:Organization
Organization Name:EASTHAMPTON COMMUNITY ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:LICAC
Authorized Official - Phone:413-203-5855
Mailing Address - Street 1:116 PLEASANT ST STE 120
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-2739
Mailing Address - Country:US
Mailing Address - Phone:413-203-5855
Mailing Address - Fax:
Practice Address - Street 1:116 PLEASANT ST STE 120
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-2739
Practice Address - Country:US
Practice Address - Phone:413-203-5855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty