Healthcare Provider Details

I. General information

NPI: 1730242918
Provider Name (Legal Business Name): MRS. FLYURA BERNSTEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 TREMONT STREET ETANT A SPA FOR WELL BEING
BOSTON MA
02146
US

IV. Provider business mailing address

524 TREMONT STREET ETANT A SPA FOR WELL BEING
BOSTON MA
02146
US

V. Phone/Fax

Practice location:
  • Phone: 617-423-5040
  • Fax:
Mailing address:
  • Phone: 617-423-5040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number216135
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: