| Xiaorong He Physician Pc | |
|
8701 Justice Ave Elmhurst NY 11373-4556 | |
| (718) 699-5283 | |
| Not Available |
| Full Name | Xiaorong He Physician Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8701 Justice Ave, Elmhurst, New York |
| Authorized Official Name and Position | Xiaorong He (OWNER) |
| Authorized Official Contact | 7186995283 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Xiaorong He Physician Pc 8701 Justice Ave Elmhurst NY 11373-4556 Ph: (718) 699-5283 | Xiaorong He Physician Pc 8701 Justice Ave Elmhurst NY 11373-4556 Ph: (718) 699-5283 |
| NPI Number | 1285813543 |
|---|---|
| Provider Enumeration Date | 11/02/2007 |
| Last Update Date | 08/27/2008 |
| Medicare PECOS PAC ID | 6608964887 |
|---|---|
| Medicare Enrollment ID | O20071126000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285813543 | NPI | - | NPPES |
| 01723179 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 199886 (New York) | Primary |
| Provider Name | Xiaorong He |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962422972 PECOS PAC ID: 1759375322 Enrollment ID: I20101103000586 |
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