Provider Demographics
NPI:1669529889
Name:REN, XINGCONG (CA)
Entity type:Individual
Prefix:
First Name:XINGCONG
Middle Name:
Last Name:REN
Suffix:
Gender:F
Credentials:CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E UNION AVE
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1711
Mailing Address - Country:US
Mailing Address - Phone:732-356-1155
Mailing Address - Fax:732-356-8229
Practice Address - Street 1:5 E UNION AVE
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1711
Practice Address - Country:US
Practice Address - Phone:732-356-1155
Practice Address - Fax:732-356-8229
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00007200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist