Provider Demographics
NPI:1366885717
Name:XU, YI (ACUPUNCTURIST)
Entity type:Individual
Prefix:PROF
First Name:YI
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14014 MULBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4143
Mailing Address - Country:US
Mailing Address - Phone:718-463-7156
Mailing Address - Fax:
Practice Address - Street 1:2367 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-5007
Practice Address - Country:US
Practice Address - Phone:718-597-2900
Practice Address - Fax:718-597-2902
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002629-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist