Healthcare Provider Details

I. General information

NPI: 1518466218
Provider Name (Legal Business Name): YIREN CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2018
Last Update Date: 02/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 EDINBORO ST STE 1
BOSTON MA
02111-2138
US

IV. Provider business mailing address

11 EDINBORO ST STE 1
BOSTON MA
02111-2138
US

V. Phone/Fax

Practice location:
  • Phone: 617-426-0680
  • Fax:
Mailing address:
  • Phone: 617-426-0680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number9184
License Number StateMA

VIII. Authorized Official

Name: KWOK BIU LEE
Title or Position: PRESIDENT
Credential:
Phone: 617-426-0680