Provider Demographics
NPI:1073304747
Name:THE MODERN ACUPUNCTURIST, LLC
Entity type:Organization
Organization Name:THE MODERN ACUPUNCTURIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:FRIEND
Authorized Official - Last Name:KRUG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:781-650-0484
Mailing Address - Street 1:43 PARK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-2134
Mailing Address - Country:US
Mailing Address - Phone:781-650-0484
Mailing Address - Fax:
Practice Address - Street 1:96 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1236
Practice Address - Country:US
Practice Address - Phone:781-650-0484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty