Provider Demographics
NPI:1326459496
Name:XU, JING (MD)
Entity Type:Individual
Prefix:DR
First Name:JING
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8708 JUSTICE AVE APT 1E
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4576
Mailing Address - Country:US
Mailing Address - Phone:718-683-9106
Mailing Address - Fax:718-683-9107
Practice Address - Street 1:8708 JUSTICE AVE APT 1E
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4576
Practice Address - Country:US
Practice Address - Phone:718-683-9106
Practice Address - Fax:718-683-9107
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290584207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty