Healthcare Provider Details
I. General information
NPI: 1164357794
Provider Name (Legal Business Name): MILLE AESTHETICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 COMMONWEALTH AVE STE 526
BOSTON MA
02215-2606
US
IV. Provider business mailing address
7 CENTRAL TER
AUBURNDALE MA
02466-2304
US
V. Phone/Fax
- Phone: 617-751-0333
- Fax:
- Phone: 617-431-6669
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
MIU LAI
NG
Title or Position: FOUNDER
Credential: NP
Phone: 617-751-0333