MEDICARE: MR. TAO XIE ACUPUNCTUREST

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	202439	MA

General Provider Information

NPI Number	:	1720134539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TAO XIE ACUPUNCTUREST

Provider Business Mailing Address
First Line	:	126 DIMMOCK ST
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169-1944
Country	:	US
Telephone Number	:	617-328-1211
Fax Number	:	617-328-1211

Provider Business Practice Location Address
First Line	:	299 NEWPORT AVE
Second Line	:	SUITE 6-7
City	:	QUINCY
State	:	MA
Zip	:	02170-1741
Country	:	US
Telephone Number	:	617-479-9001
Fax Number	:	617-479-9001

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

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	07/08/2007

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