Provider Demographics
NPI:1245408244
Name:QIU, YUXIA (LAC)
Entity Type:Individual
Prefix:
First Name:YUXIA
Middle Name:
Last Name:QIU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:YUXIA
Other - Last Name:QIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1841 BROADWAY
Mailing Address - Street 2:#509
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7603
Mailing Address - Country:US
Mailing Address - Phone:646-240-1023
Mailing Address - Fax:
Practice Address - Street 1:1841 BROADWAY
Practice Address - Street 2:#509
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7603
Practice Address - Country:US
Practice Address - Phone:646-240-1023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00568171100000X
NY4518171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist