Provider Demographics
NPI:1487659512
Name:CUI, JIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JIAN
Middle Name:
Last Name:CUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:CUI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:13620 38TH AVE
Mailing Address - Street 2:SUITE 5H
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4233
Mailing Address - Country:US
Mailing Address - Phone:718-661-9554
Mailing Address - Fax:718-661-9556
Practice Address - Street 1:13620 38TH AVE
Practice Address - Street 2:SUITE 5H
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4233
Practice Address - Country:US
Practice Address - Phone:718-661-9554
Practice Address - Fax:718-661-9556
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206610207N00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01920290Medicaid
NY1048429OtherAETNA
NY113432509Other1199
NY01920290Medicaid
NY05U171Medicare ID - Type Unspecified