Provider Demographics
NPI:1104260678
Name:KIRSCHNER, KATHIA ENGLER (MAOM)
Entity type:Individual
Prefix:
First Name:KATHIA
Middle Name:ENGLER
Last Name:KIRSCHNER
Suffix:
Gender:F
Credentials:MAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 ELM ST STE 300B
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2950
Mailing Address - Country:US
Mailing Address - Phone:617-902-8769
Mailing Address - Fax:
Practice Address - Street 1:80 GOVERNORS AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3018
Practice Address - Country:US
Practice Address - Phone:617-902-8769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA257100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist