1326271180 NPI number — THAI MASSAGE AND ACUPUNCTURE

Table of content: RANDY ART MARTINEZ LPC, LCDC, LSSP (NPI 1962235127)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326271180 NPI number — THAI MASSAGE AND ACUPUNCTURE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THAI MASSAGE AND ACUPUNCTURE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326271180
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1431 HANCOCK ST STE 2
Provider Second Line Business Mailing Address:
THAI MASSAGE AND ACUPUNCUTURE
Provider Business Mailing Address City Name:
QUINCY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02169-5217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
857-234-6791
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1431 HANCOCK ST STE 2
Provider Second Line Business Practice Location Address:
THAI MASSAGE AND ACUPUNCUTURE
Provider Business Practice Location Address City Name:
QUINCY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02169-5217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
857-234-6791
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/27/2009

Additional Information

Authorized Official

Authorized Official Last Name:
FRANCOIS
Authorized Official First Name:
LING
Authorized Official Middle Name:
SHEUNG
Authorized Official Title or Position:
OWER
Authorized Official Telephone Number:
857-234-6791

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , with the licence number:  4423 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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