Provider Demographics
NPI:1992093504
Name:CHONG, XUE XIA (L AC)
Entity type:Individual
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First Name:XUE XIA
Middle Name:
Last Name:CHONG
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Gender:F
Credentials:L AC
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Mailing Address - Street 1:1062 67TH ST
Mailing Address - Street 2:APT 3B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-5980
Mailing Address - Country:US
Mailing Address - Phone:917-603-3906
Mailing Address - Fax:631-444-1230
Practice Address - Street 1:1062 67TH ST
Practice Address - Street 2:APT 3B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-5980
Practice Address - Country:US
Practice Address - Phone:917-603-3906
Practice Address - Fax:631-444-1230
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-17
Last Update Date:2012-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY25004509171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist