Healthcare Provider Details

I. General information

NPI: 1881864247
Provider Name (Legal Business Name): PAI JUNG HUANG M.D.,
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2008
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 OLIVE ST
WINCHESTER MA
01890-2027
US

IV. Provider business mailing address

12 OLIVE ST
WINCHESTER MA
01890-2027
US

V. Phone/Fax

Practice location:
  • Phone: 781-588-3885
  • Fax:
Mailing address:
  • Phone: 781-588-3885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number224292
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: