Provider Demographics
NPI:1265654909
Name:YANG, XIAOSI (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MS
First Name:XIAOSI
Middle Name:
Last Name:YANG
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 1:4128 71ST ST
Mailing Address - Street 2:SUITE CB
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3966
Mailing Address - Country:US
Mailing Address - Phone:718-397-5349
Mailing Address - Fax:718-606-2728
Practice Address - Street 1:4128 71ST ST
Practice Address - Street 2:SUITE CB
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3966
Practice Address - Country:US
Practice Address - Phone:718-397-5349
Practice Address - Fax:718-606-2728
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000391171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist