Healthcare Provider Details

I. General information

NPI: 1831775345
Provider Name (Legal Business Name): JENNIFER PEIYAO XIE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ZHENNI XIE

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MEDICAL CENTER DR STE 308
SPRINGFIELD MA
01107-1271
US

IV. Provider business mailing address

280 CHESTNUT ST FL 2
SPRINGFIELD MA
01199-1001
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-7020
  • Fax: 413-794-2670
Mailing address:
  • Phone: 413-794-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number1026234
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: