Provider Demographics
NPI:1275608861
Name:SHANG, XUE-CHENG
Entity Type:Individual
Prefix:MR
First Name:XUE-CHENG
Middle Name:
Last Name:SHANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PINEVIEW TER
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-6044
Mailing Address - Country:US
Mailing Address - Phone:607-272-4262
Mailing Address - Fax:
Practice Address - Street 1:104 PINEVIEW TER
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-6044
Practice Address - Country:US
Practice Address - Phone:607-272-4262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000852171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist