Provider Demographics
NPI:1730136607
Name:GAO, XIAO-KE (MD)
Entity Type:Individual
Prefix:
First Name:XIAO-KE
Middle Name:
Last Name:GAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JUDY
Other - Middle Name:
Other - Last Name:GAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:106 SHEEPHILL RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CT
Mailing Address - Zip Code:06878-1120
Mailing Address - Country:US
Mailing Address - Phone:212-889-6540
Mailing Address - Fax:203-637-7724
Practice Address - Street 1:196 CANAL ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4562
Practice Address - Country:US
Practice Address - Phone:212-227-6500
Practice Address - Fax:212-889-4987
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2043382084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01822444Medicaid