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NPI Code Detail

MEDICARE: MS. KIM LEAH FOSTER L.AC

MEDICARE: MS. KIM LEAH FOSTER L.AC
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
1171100000XAcupuncturist235317MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1235317OTHERMALICENSED ACUPUNCTURIST

General Provider Information

NPI Number : 1104072529
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIM LEAH FOSTER L.AC
Provider Business Mailing Address
First Line : 4 COGSWELL AVE APT 24
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02140-2027
Country : US
Telephone Number : 617-230-1910
Fax Number :
Provider Business Practice Location Address
First Line : 53 LANGLEY RD STE 340
Second Line :
City : NEWTON
State : MA
Zip : 02459-1919
Country : US
Telephone Number : 617-230-1910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2008
Last Update Date : 08/18/2008

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Directions to “ MS. KIM LEAH FOSTER L.AC” Practice Location

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