Provider Demographics
NPI:1831317429
Name:ZHANG, QI XIAN (LAC)
Entity Type:Individual
Prefix:
First Name:QI
Middle Name:XIAN
Last Name:ZHANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 MURRAY ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4933
Mailing Address - Country:US
Mailing Address - Phone:917-981-8767
Mailing Address - Fax:718-886-9655
Practice Address - Street 1:13529 40TH RD STE 2
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5312
Practice Address - Country:US
Practice Address - Phone:917-981-8767
Practice Address - Fax:718-886-9655
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000542171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3099153OtherOXFORD HEALTH PLANS