Healthcare Provider Details

I. General information

NPI: 1568319689
Provider Name (Legal Business Name): XUAN CUI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 DIMOCK ST
ROXBURY MA
02119-1208
US

IV. Provider business mailing address

33 PAUL ST APT 20
NEWTON CENTER MA
02459-2472
US

V. Phone/Fax

Practice location:
  • Phone: 617-442-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number8391
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: