Provider Demographics
NPI:1407317738
Name:XINING HE PHYSICIAN PC
Entity Type:Organization
Organization Name:XINING HE PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:XINING
Authorized Official - Middle Name:
Authorized Official - Last Name:HE
Authorized Official - Suffix:
Authorized Official - Credentials:MDD
Authorized Official - Phone:718-559-0118
Mailing Address - Street 1:136-20 38TH AVENUE
Mailing Address - Street 2:SUITE 7G
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4232
Mailing Address - Country:US
Mailing Address - Phone:718-559-0118
Mailing Address - Fax:718-559-0117
Practice Address - Street 1:136-20 38TH AVENUE
Practice Address - Street 2:SUITE 7G
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4232
Practice Address - Country:US
Practice Address - Phone:718-559-0118
Practice Address - Fax:718-559-0117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty