Lisa Blake, LIC. AC.

Individual provider Active NPI Acupuncturist · Medford, MA

NPI 1457767907 · NPPES record last updated Aug 24, 2016

Key facts

NPI
1457767907
Entity type
Individual (NPI type 1)
Primary specialty
Acupuncturist 171100000X
Practice address
16 Bradlee Rd
Medford, MA 02155-3171
Phone
(781) 269-2849
NPI assigned
Jul 5, 2014
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Blake Acupuncture & Herbal Medicine Acupuncturist Current Accepting new patients

Locations

16 Bradlee Rd
Medford, MA 02155
Phone (617) 797-6547

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X Yes

Addresses

Primary practice location

16 Bradlee Rd
Medford, MA 02155-3171

Mailing address

81 High St # 2
Waltham, MA 02453-0545
Phone (804) 931-8288

Other providers in Medford, MA

All providers in Medford, MA · Acupuncturist in Massachusetts

Sources for this page

Verify at the official NPI Registry.