Provider Demographics
NPI:1700276557
Name:TRANSFORM INSTITUTE FOR METABOLIC & LIFESTYLE MEDICINE, LLC
Entity Type:Organization
Organization Name:TRANSFORM INSTITUTE FOR METABOLIC & LIFESTYLE MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUI-SHIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-549-3660
Mailing Address - Street 1:150 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1005
Mailing Address - Country:US
Mailing Address - Phone:203-998-5377
Mailing Address - Fax:617-924-4314
Practice Address - Street 1:150 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1005
Practice Address - Country:US
Practice Address - Phone:617-549-3660
Practice Address - Fax:617-395-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152351207R00000X, 207RB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty