Provider Demographics
NPI:1053523472
Name:XU, HONG (ACUPUNCTURIST)
Entity type:Individual
Prefix:MRS
First Name:HONG
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:DR
Other - First Name:HONG
Other - Middle Name:
Other - Last Name:XU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DA
Mailing Address - Street 1:240 MOOSEHORN RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH,
Mailing Address - State:RI
Mailing Address - Zip Code:02818
Mailing Address - Country:US
Mailing Address - Phone:401-396-4068
Mailing Address - Fax:
Practice Address - Street 1:1 BLACKSTONE PL
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4942
Practice Address - Country:US
Practice Address - Phone:401-369-4068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25003258171100000X
CAAC 5036171100000X
RIDA00321171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist