Healthcare Provider Details

I. General information

NPI: 1285701912
Provider Name (Legal Business Name): MARC H GERSTEIN LIC. AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 GULF RD
BELCHERTOWN MA
01007-9729
US

IV. Provider business mailing address

81 GULF RD
BELCHERTOWN MA
01007-9729
US

V. Phone/Fax

Practice location:
  • Phone: 413-374-6756
  • Fax:
Mailing address:
  • Phone: 860-243-3903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number165
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: