Provider Demographics
NPI:1659009454
Name:KE, XIAOHONG
Entity Type:Individual
Prefix:DR
First Name:XIAOHONG
Middle Name:
Last Name:KE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CANTERBURY RD APT B5
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2601
Mailing Address - Country:US
Mailing Address - Phone:917-518-3769
Mailing Address - Fax:
Practice Address - Street 1:15 CANTERBURY RD APT B5
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2601
Practice Address - Country:US
Practice Address - Phone:917-518-3769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003549171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist