Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 273820 | NY |
NPI | 1063700490 |
---|---|
Provider Name | Yan Yan Sally Xie |
First Address | Great Neck, NY 11021-5335 |
Second Address | Great Neck, NY 11021-5335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2011 |
Last Update Date | 29/09/2016 |