MEDICARE: ROBERTA NMI LENARD MAOM (PENDING)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist		MA

General Provider Information

NPI Number	:	1023492105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERTA NMI LENARD MAOM (PENDING)

Provider Business Mailing Address
First Line	:	471 MASSACHUSETTS AVE
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02474-5103
Country	:	US
Telephone Number	:	617-645-9940
Fax Number	:

Provider Business Practice Location Address
First Line	:	471 MASSACHUSETTS AVE
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02474-5103
Country	:	US
Telephone Number	:	617-645-9940
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2015
Last Update Date	:	07/17/2015

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Directions to “ ROBERTA NMI LENARD MAOM (PENDING)” Practice Location

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