=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548338445
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | XIAOQIANG ZHAO LIC. AC.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29 PRAY ST
-----------------------------------------------------
City | AMHERST
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01002-2110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-549-9944
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 51 PONDVIEW DR
-----------------------------------------------------
City | AMHERST
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01002-3229
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-549-9944
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 216701
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------