Provider Demographics
NPI:1790957272
Name:CHINESE ACUPUNCTURE AND HERBAL MEDICA
Entity Type:Organization
Organization Name:CHINESE ACUPUNCTURE AND HERBAL MEDICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENCED ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHENG
Authorized Official - Suffix:
Authorized Official - Credentials:PH D IN NEUROSCIENC
Authorized Official - Phone:617-817-1910
Mailing Address - Street 1:475 HILLSIDE AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-1200
Mailing Address - Country:US
Mailing Address - Phone:781-449-1813
Mailing Address - Fax:
Practice Address - Street 1:475 HILLSIDE AVE STE 3
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-1200
Practice Address - Country:US
Practice Address - Phone:781-449-1813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204653171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty