Provider Demographics
NPI:1104903962
Name:ZHANG, MANHUA (LIC AC)
Entity type:Individual
Prefix:MRS
First Name:MANHUA
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
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 1:141 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2426
Mailing Address - Country:US
Mailing Address - Phone:617-244-1624
Mailing Address - Fax:617-244-1624
Practice Address - Street 1:50 UNION ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-2223
Practice Address - Country:US
Practice Address - Phone:617-527-5528
Practice Address - Fax:617-527-7988
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA702171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist