Provider Demographics
NPI:1932933249
Name:XIA, CHENGCHENG
Entity type:Individual
Prefix:
First Name:CHENGCHENG
Middle Name:
Last Name:XIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-5201
Mailing Address - Country:US
Mailing Address - Phone:347-925-1680
Mailing Address - Fax:
Practice Address - Street 1:16 CEDAR ST
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-5201
Practice Address - Country:US
Practice Address - Phone:347-925-1680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist