Provider Demographics
NPI:1912660499
Name:XIAO, CHUAN
Entity Type:Individual
Prefix:
First Name:CHUAN
Middle Name:
Last Name:XIAO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 JASON PL STE 201
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-1909
Mailing Address - Country:US
Mailing Address - Phone:845-800-5118
Mailing Address - Fax:
Practice Address - Street 1:14 JASON PL STE 201
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-1909
Practice Address - Country:US
Practice Address - Phone:845-800-5118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAC-2071171100000X
NY007347171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist