Provider Demographics
NPI:1588391429
Name:CONSCIOUS ACUPUNCTURE AND HERBS LLC
Entity type:Organization
Organization Name:CONSCIOUS ACUPUNCTURE AND HERBS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTANTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-635-9754
Mailing Address - Street 1:264 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-1236
Mailing Address - Country:US
Mailing Address - Phone:781-635-9754
Mailing Address - Fax:781-982-0048
Practice Address - Street 1:277 MAIN ST STE 208
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-5521
Practice Address - Country:US
Practice Address - Phone:781-635-9754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty