Healthcare Provider Details

I. General information

NPI: 1598832230
Provider Name (Legal Business Name): XUPING TANG LIC. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HOLDEN ST SUITE 209A
MALDEN MA
02148-5238
US

IV. Provider business mailing address

505 W HOLLIS ST SUITE 209A
NASHUA NH
03062-1358
US

V. Phone/Fax

Practice location:
  • Phone: 781-526-7800
  • Fax:
Mailing address:
  • Phone: 781-526-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number202436
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: