Provider Demographics
NPI:1619380979
Name:ADVANCEXING PAIN AND REHAB CLINIC PA
Entity Type:Organization
Organization Name:ADVANCEXING PAIN AND REHAB CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSIAN
Authorized Official - Prefix:
Authorized Official - First Name:SELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:XING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-384-7439
Mailing Address - Street 1:620 STANTON CHRISTIANA RD STE 202
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2130
Mailing Address - Country:US
Mailing Address - Phone:302-384-7439
Mailing Address - Fax:302-384-7443
Practice Address - Street 1:620 STANTON CHRISTIANA RD STE 202
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2130
Practice Address - Country:US
Practice Address - Phone:302-384-7439
Practice Address - Fax:302-384-7443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10006679332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site