Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fannie Tan Koa, LICAC, DIPLOM

Individual provider Acupuncturist · NPI 1588925077

Fannie Tan Koa, LICAC, DIPLOM is an Acupuncturist in Somerville, Massachusetts. Practices as a sole proprietor. Licensed in Massachusetts and New Hampshire.

Licensed in
MA, NH
In the registry since
2012
Specialties on file
2
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Practice location Address checks out

259 Elm St Ste 300B
Somerville, MA 02144-2950
Phone: (617) 294-9109
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acupuncturist (primary) Taxonomy 171100000X · Licence 253925 (MA)
Acupuncturist Taxonomy 171100000X · Licence 205 (NH)

Record details

NPI number1588925077
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICAC , DIPLOM
Sole proprietorYes
NPI enumeratedMay 31, 2012
Last updated in NPPESFebruary 15, 2017

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