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General NPI Number Information
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NPI Number | 1174747307
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Entity Type | Individual
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Provider Name | SHARON ELAINE PRUSS L.AC., DIPL.AC.
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 09/04/2021
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Provider Practice Location Address
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Address Line | 240 BEDFORD ST STE 5
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City | LEXINGTON
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State | MA
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Zip | 02420-3400
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Country | US
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Telephone | 310-621-4553
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Fax | 310-634-1818
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Provider Business Mailing Address
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Address Line | 275 CYPRESS ST APT 203
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City | BROOKLINE
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State | MA
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Zip | 02445-6774
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Country | US
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Telephone | 310-621-4553
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | DA00488
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 9560
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 279433
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License Number State | MA
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