Provider Demographics
NPI:1144731324
Name:ACUPUNCTURE & QIGONG FOR INTEGRAL HEALTH
Entity type:Organization
Organization Name:ACUPUNCTURE & QIGONG FOR INTEGRAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUI
Authorized Official - Middle Name:WANG
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:ACUPUNCTRIST
Authorized Official - Phone:617-997-9922
Mailing Address - Street 1:366 MASSACHUSETTS AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-6732
Mailing Address - Country:US
Mailing Address - Phone:617-997-9922
Mailing Address - Fax:978-510-5356
Practice Address - Street 1:366 MASSACHUSETTS AVE STE 303
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-6732
Practice Address - Country:US
Practice Address - Phone:617-997-9922
Practice Address - Fax:978-510-5356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1518034255Medicaid