Provider Demographics
NPI:1437638558
Name:BINGRU XIE DIGESTIVE DISEASES ASSOCIATES MEDICAL PC
Entity type:Organization
Organization Name:BINGRU XIE DIGESTIVE DISEASES ASSOCIATES MEDICAL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BINGRU
Authorized Official - Middle Name:
Authorized Official - Last Name:XIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-461-7553
Mailing Address - Street 1:211 BRIDGE ST BLDG D
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2254
Mailing Address - Country:US
Mailing Address - Phone:732-662-5115
Mailing Address - Fax:
Practice Address - Street 1:211 BRIDGE ST BLDG D
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2254
Practice Address - Country:US
Practice Address - Phone:518-461-7553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-09
Last Update Date:2018-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ327361Medicaid