Provider Demographics
NPI:1952500795
Name:CLANCY, RICHARD JAMES (LIC AC M AC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:JAMES
Last Name:CLANCY
Suffix:
Gender:M
Credentials:LIC AC M AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-3341
Mailing Address - Country:US
Mailing Address - Phone:781-878-2667
Mailing Address - Fax:
Practice Address - Street 1:6 GROVE ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1534
Practice Address - Country:US
Practice Address - Phone:781-878-2667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223867171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist