Provider Demographics
NPI:1205153723
Name:LUO, SEAN XIAO (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:XIAO
Last Name:LUO
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W 88TH ST APT 1C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2324
Mailing Address - Country:US
Mailing Address - Phone:646-918-3780
Mailing Address - Fax:646-786-3772
Practice Address - Street 1:215 W 88TH ST APT 1C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2324
Practice Address - Country:US
Practice Address - Phone:646-918-3780
Practice Address - Fax:646-786-3772
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2619342084P0802X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
46-4310631OtherIRS EIN