Provider Demographics
NPI:1982733168
Name:MARGOLIN, NARA (LIC AC)
Entity type:Individual
Prefix:
First Name:NARA
Middle Name:
Last Name:MARGOLIN
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 1:193 UPLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02461-2001
Mailing Address - Country:US
Mailing Address - Phone:617-308-3617
Mailing Address - Fax:
Practice Address - Street 1:19 BELMONT ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4404
Practice Address - Country:US
Practice Address - Phone:617-308-3617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226651171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist