Provider Demographics
NPI:1205919313
Name:XIAO, YONG HONG (MD)
Entity type:Individual
Prefix:DR
First Name:YONG HONG
Middle Name:
Last Name:XIAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132-03 SANFORD AVE
Mailing Address - Street 2:1C/1D
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3105
Mailing Address - Country:US
Mailing Address - Phone:718-961-8881
Mailing Address - Fax:718-961-4333
Practice Address - Street 1:13203 SANFORD AVE
Practice Address - Street 2:1C/1D
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4309
Practice Address - Country:US
Practice Address - Phone:718-961-8881
Practice Address - Fax:718-961-4333
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224337208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246075Medicaid
NY00246075Medicaid
NY0033T128Medicare ID - Type Unspecified