Provider Demographics
NPI:1558688754
Name:XIE, YI (MD PHD)
Entity Type:Individual
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First Name:YI
Middle Name:
Last Name:XIE
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Gender:M
Credentials:MD PHD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:139 CENTRE ST STE 715A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4557
Mailing Address - Country:US
Mailing Address - Phone:901-279-3831
Mailing Address - Fax:917-398-2126
Practice Address - Street 1:139 CENTRE ST STE 715A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4557
Practice Address - Country:US
Practice Address - Phone:901-279-3831
Practice Address - Fax:917-398-2126
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2677832084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology