Provider Demographics
NPI:1447408216
Name:XIONG, WEN (MD)
Entity Type:Individual
Prefix:DR
First Name:WEN
Middle Name:
Last Name:XIONG
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 1:2280 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:VAUXHALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07088-1123
Mailing Address - Country:US
Mailing Address - Phone:908-688-1288
Mailing Address - Fax:908-688-1588
Practice Address - Street 1:2280 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1123
Practice Address - Country:US
Practice Address - Phone:908-688-1288
Practice Address - Fax:908-688-1588
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08711600207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0243248Medicaid
NJ0243248Medicaid