Provider Demographics
NPI:1811029788
Name:LI, MING 0 (LIC AC)
Entity Type:Individual
Prefix:
First Name:MING
Middle Name:0
Last Name:LI
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:70A BEACONWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON HIGHLANDS
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1127
Mailing Address - Country:US
Mailing Address - Phone:617-278-9988
Mailing Address - Fax:
Practice Address - Street 1:2001 BEACON STREET
Practice Address - Street 2:SUITE -B
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445
Practice Address - Country:US
Practice Address - Phone:617-278-9988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA634171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist