Provider Demographics
NPI:1265245443
Name:XU, JINGHUA (PHD, HCLD(ABB))
Entity type:Individual
Prefix:
First Name:JINGHUA
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:PHD, HCLD(ABB)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1862 ROYAL MAJESTY CT
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6637
Mailing Address - Country:US
Mailing Address - Phone:734-239-3059
Mailing Address - Fax:
Practice Address - Street 1:3070 MCCANN FARM DR STE 112
Practice Address - Street 2:
Practice Address - City:GARNET VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19060-2131
Practice Address - Country:US
Practice Address - Phone:734-239-3059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDI58386247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician