Provider Demographics
NPI:1184987067
Name:ZHAO, XIAOHONG (LAC)
Entity type:Individual
Prefix:
First Name:XIAOHONG
Middle Name:
Last Name:ZHAO
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 1:251 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3218
Mailing Address - Country:US
Mailing Address - Phone:609-742-8000
Mailing Address - Fax:212-448-9338
Practice Address - Street 1:30 E 40TH ST
Practice Address - Street 2:PH-SE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1201
Practice Address - Country:US
Practice Address - Phone:609-742-8000
Practice Address - Fax:212-448-9338
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-16
Last Update Date:2012-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004817171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist