Provider Demographics
NPI:1720134539
Name:XIE, TAO (ACUPUNCTUREST)
Entity Type:Individual
Prefix:MR
First Name:TAO
Middle Name:
Last Name:XIE
Suffix:
Gender:M
Credentials:ACUPUNCTUREST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 DIMMOCK ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1944
Mailing Address - Country:US
Mailing Address - Phone:617-328-1211
Mailing Address - Fax:617-328-1211
Practice Address - Street 1:299 NEWPORT AVE
Practice Address - Street 2:SUITE 6-7
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02170-1741
Practice Address - Country:US
Practice Address - Phone:617-479-9001
Practice Address - Fax:617-479-9001
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA202439171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist