Healthcare Provider Details

I. General information

NPI: 1972624039
Provider Name (Legal Business Name): PAMELA A MENDONCA LIC. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EAST WIND ACUPUNCTURE 210 NORTH HAVERHILL ROAD
KENSINGTON NH
03827
US

IV. Provider business mailing address

64 ELMWOOD ST
SALISBURY MA
01952-1012
US

V. Phone/Fax

Practice location:
  • Phone: 603-778-7180
  • Fax:
Mailing address:
  • Phone: 603-778-7180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number205543
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: