Provider Demographics
NPI:1881158897
Name:YUANLI XIE MEDICAL PC
Entity type:Organization
Organization Name:YUANLI XIE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:YUANLI
Authorized Official - Middle Name:
Authorized Official - Last Name:XIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-268-5286
Mailing Address - Street 1:1664 BAY RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-5135
Mailing Address - Country:US
Mailing Address - Phone:347-268-5286
Mailing Address - Fax:
Practice Address - Street 1:8504 21ST AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3208
Practice Address - Country:US
Practice Address - Phone:347-766-2262
Practice Address - Fax:718-676-5365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty