Provider Demographics
NPI:1588037436
Name:ZHAO, XIAOYAN (MD)
Entity Type:Individual
Prefix:
First Name:XIAOYAN
Middle Name:
Last Name:ZHAO
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 1:10 WESTON AVE APT 226
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170-1842
Mailing Address - Country:US
Mailing Address - Phone:857-265-0493
Mailing Address - Fax:
Practice Address - Street 1:10 WESTON AVE APT 226
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02170-1842
Practice Address - Country:US
Practice Address - Phone:857-265-0493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-31
Last Update Date:2015-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
100213832338OtherMASSHEALTH