Provider Demographics
NPI:1598284986
Name:XIE, FEN (OMD)
Entity Type:Individual
Prefix:MS
First Name:FEN
Middle Name:
Last Name:XIE
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 N HARRISON ST STE 5
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3500
Mailing Address - Country:US
Mailing Address - Phone:609-683-9599
Mailing Address - Fax:
Practice Address - Street 1:330 N HARRISON ST STE 5
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3500
Practice Address - Country:US
Practice Address - Phone:609-683-9599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00004100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist