Provider Demographics
NPI:1467759845
Name:XIE JIANLIN GASTROENTEROLOGY & HEPATOLOGY PLLC
Entity Type:Organization
Organization Name:XIE JIANLIN GASTROENTEROLOGY & HEPATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JIANLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:XIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:718-321-8840
Mailing Address - Street 1:4160 MAIN ST
Mailing Address - Street 2:201A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4160 MAIN ST
Practice Address - Street 2:201A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3806
Practice Address - Country:US
Practice Address - Phone:718-321-8840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-19
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241857207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty