Provider Demographics
NPI:1811120090
Name:XU, AIMING (MB LIC AC)
Entity type:Individual
Prefix:
First Name:AIMING
Middle Name:
Last Name:XU
Suffix:
Gender:M
Credentials:MB LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 KNOB HILL ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-3118
Mailing Address - Country:US
Mailing Address - Phone:617-696-0818
Mailing Address - Fax:
Practice Address - Street 1:38 KNOB HILL ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-3118
Practice Address - Country:US
Practice Address - Phone:617-696-0818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA512171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist