Provider Demographics
NPI:1689790131
Name:HUNG, CALEB (ACUPUNCTURIST)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:HUNG
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 HARRISON ST APT C
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-2173
Mailing Address - Country:US
Mailing Address - Phone:781-299-4719
Mailing Address - Fax:
Practice Address - Street 1:256 HANOVER ST STE 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02113-2337
Practice Address - Country:US
Practice Address - Phone:617-356-1368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00403171100000X
MA206116171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist