Provider Demographics
NPI:1902004575
Name:CHOI, ALICE J (LICAC)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:J
Last Name:CHOI
Suffix:
Gender:F
Credentials:LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:214 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7622
Mailing Address - Country:US
Mailing Address - Phone:617-232-0110
Mailing Address - Fax:617-232-0114
Practice Address - Street 1:214 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7622
Practice Address - Country:US
Practice Address - Phone:617-232-0110
Practice Address - Fax:617-232-0114
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219530171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist