Provider Demographics
NPI:1548328883
Name:LEE, CHI CHIAO
Entity type:Individual
Prefix:MR
First Name:CHI
Middle Name:CHIAO
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 WEBSTER ST
Mailing Address - Street 2:2#
Mailing Address - City:AUBURNDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02466-2105
Mailing Address - Country:US
Mailing Address - Phone:617-451-7246
Mailing Address - Fax:617-451-7246
Practice Address - Street 1:72 KNEELAND ST
Practice Address - Street 2:SUITE 404
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1919
Practice Address - Country:US
Practice Address - Phone:617-451-7246
Practice Address - Fax:617-451-7246
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0211171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist