Healthcare Provider Details

I. General information

NPI: 1679221055
Provider Name (Legal Business Name): ANNA KUWAHARA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92A SUMMER ST
WATERTOWN MA
02472-3816
US

IV. Provider business mailing address

92A SUMMER ST
WATERTOWN MA
02472-3816
US

V. Phone/Fax

Practice location:
  • Phone: 617-678-5012
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: