Provider Demographics
NPI:1275657223
Name:GIEBISCH, NINRONG XUE (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:NINRONG
Middle Name:XUE
Last Name:GIEBISCH
Suffix:
Gender:F
Credentials:MD,PHD
Other - Prefix:DR
Other - First Name:NINRONG
Other - Middle Name:
Other - Last Name:XUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD,PHD
Mailing Address - Street 1:85 FOREST GLEN DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-1422
Mailing Address - Country:US
Mailing Address - Phone:203-387-5581
Mailing Address - Fax:
Practice Address - Street 1:200 WATSON BLVD
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-7127
Practice Address - Country:US
Practice Address - Phone:203-381-4917
Practice Address - Fax:203-381-4004
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT036383174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist