Provider Demographics
NPI:1649724303
Name:YU, XIAOYU
Entity type:Individual
Prefix:
First Name:XIAOYU
Middle Name:
Last Name:YU
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 1:133 GRAND ST
Mailing Address - Street 2:APT 4B
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4453
Mailing Address - Country:US
Mailing Address - Phone:860-710-4193
Mailing Address - Fax:
Practice Address - Street 1:133 GRAND ST
Practice Address - Street 2:APT 4B
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4453
Practice Address - Country:US
Practice Address - Phone:860-710-4193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY716595163W00000X
NJ26NR18378900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse