Provider Demographics
NPI:1184888232
Name:FELDMAN, MARTIN (LIC AC)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE JAPANESE ACUPUNCTURE CTR.
Mailing Address - Street 2:124 WATERTOWN STREET
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472
Mailing Address - Country:US
Mailing Address - Phone:617-926-4076
Mailing Address - Fax:
Practice Address - Street 1:THE JAPANESE ACUPUNCTURE CTR.
Practice Address - Street 2:124 WATERTOWN STREET
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472
Practice Address - Country:US
Practice Address - Phone:617-926-4076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA88171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist