Provider Demographics
NPI:1952668550
Name:QIU, XUAN (MD/PHD)
Entity type:Individual
Prefix:
First Name:XUAN
Middle Name:
Last Name:QIU
Suffix:
Gender:F
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3712 PRINCE ST STE 6D
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4651
Mailing Address - Country:US
Mailing Address - Phone:631-235-0000
Mailing Address - Fax:347-808-2178
Practice Address - Street 1:3712 PRINCE ST STE 6D
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4651
Practice Address - Country:US
Practice Address - Phone:631-235-0000
Practice Address - Fax:347-808-2178
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY295123207X00000X
390200000X
MI4301113478390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program