Provider Demographics
NPI:1902054976
Name:XIE, WENFEI (LIC AC)
Entity Type:Individual
Prefix:
First Name:WENFEI
Middle Name:
Last Name:XIE
Suffix:
Gender:F
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 1:1244 BOYLSTON ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2116
Mailing Address - Country:US
Mailing Address - Phone:617-264-9155
Mailing Address - Fax:
Practice Address - Street 1:1244 BOYLSTON ST
Practice Address - Street 2:SUITE 203
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2116
Practice Address - Country:US
Practice Address - Phone:617-264-9155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA214171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist