Provider Demographics
NPI:1245300805
Name:GINSBERG, ALAN MICHAEL (LIC AC)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:MICHAEL
Last Name:GINSBERG
Suffix:
Gender:M
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RANGER RD
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3209
Mailing Address - Country:US
Mailing Address - Phone:617-429-8484
Mailing Address - Fax:
Practice Address - Street 1:3 RANGER RD
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3209
Practice Address - Country:US
Practice Address - Phone:617-429-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA006171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist