Provider Demographics
NPI:1346837952
Name:JING XU MD, PLLC
Entity Type:Organization
Organization Name:JING XU MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JING
Authorized Official - Middle Name:
Authorized Official - Last Name:XU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-683-9106
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty