Provider Demographics
NPI:1083216188
Name:XIA, WEN (L AC)
Entity type:Individual
Prefix:MRS
First Name:WEN
Middle Name:
Last Name:XIA
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 W 34TH ST RM 402
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-0071
Mailing Address - Country:US
Mailing Address - Phone:646-898-9984
Mailing Address - Fax:
Practice Address - Street 1:1 W 34TH ST RM 402
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-0071
Practice Address - Country:US
Practice Address - Phone:332-207-0610
Practice Address - Fax:631-201-4427
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006789171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist