Provider Demographics
NPI:1912904269
Name:XIN QUAN MEDICAL REHABILITATION AND ACUPUNCTURE, PLLC
Entity Type:Organization
Organization Name:XIN QUAN MEDICAL REHABILITATION AND ACUPUNCTURE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:XIN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-285-3480
Mailing Address - Street 1:33 BAKER AVENUE
Mailing Address - Street 2:PROF. UNITE #2
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1635
Mailing Address - Country:US
Mailing Address - Phone:914-285-3480
Mailing Address - Fax:914-285-3479
Practice Address - Street 1:33 BAKER AVENUE
Practice Address - Street 2:PROF. UNITE # 2
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-1635
Practice Address - Country:US
Practice Address - Phone:914-285-3480
Practice Address - Fax:914-285-3479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-01
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220271208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7117637OtherAETNA
NY2465872OtherUNITED HEALTH CARE
NY=========OtherPOMCO
NY7117637OtherAETNA
NYH44793Medicare UPIN