Provider Demographics
NPI:1538820592
Name:FANG, SAIGE XUEQI (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:SAIGE
Middle Name:XUEQI
Last Name:FANG
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 MARKET ST FL 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5545
Mailing Address - Country:US
Mailing Address - Phone:215-662-9900
Mailing Address - Fax:215-243-4641
Practice Address - Street 1:3737 MARKET ST FL 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5545
Practice Address - Country:US
Practice Address - Phone:215-662-9900
Practice Address - Fax:215-243-4641
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-03
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024965363LP2300X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care