Provider Demographics
NPI:1972835288
Name:XIE, DUO
Entity Type:Individual
Prefix:
First Name:DUO
Middle Name:
Last Name:XIE
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 1:2112 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-1404
Mailing Address - Country:US
Mailing Address - Phone:718-597-3000
Mailing Address - Fax:718-597-7842
Practice Address - Street 1:2112 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-1404
Practice Address - Country:US
Practice Address - Phone:718-597-3000
Practice Address - Fax:718-597-7842
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist