Provider Demographics
NPI:1538344858
Name:RAMON, MICHAL (LIC AC MAOM)
Entity type:Individual
Prefix:MRS
First Name:MICHAL
Middle Name:
Last Name:RAMON
Suffix:
Gender:F
Credentials:LIC AC MAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-6824
Mailing Address - Country:US
Mailing Address - Phone:781-863-0380
Mailing Address - Fax:781-652-8683
Practice Address - Street 1:238 BEDFORD ST
Practice Address - Street 2:SUITE #5
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-3440
Practice Address - Country:US
Practice Address - Phone:781-424-8515
Practice Address - Fax:781-652-8683
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-05
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227017171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist