Provider Demographics
NPI:1285968610
Name:GERMAN, JACQUELINE SAVETSKY (LIC AC)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:SAVETSKY
Last Name:GERMAN
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 1:6 ARBOROUGH RD # 2
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-1602
Mailing Address - Country:US
Mailing Address - Phone:857-719-3078
Mailing Address - Fax:
Practice Address - Street 1:1895 CENTRE ST
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-1933
Practice Address - Country:US
Practice Address - Phone:857-719-3078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227410171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA227410OtherMASSACHUSETTS LICENSE TO PRACTICE ACUPUNCTURE