Healthcare Provider Details

I. General information

NPI: 1487659512
Provider Name (Legal Business Name): JIAN CUI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAMES CUI M.D.

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 02/15/2021
Certification Date: 02/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13620 38TH AVE SUITE 5H
FLUSHING NY
11354-4233
US

IV. Provider business mailing address

13620 38TH AVE SUITE 5H
FLUSHING NY
11354-4233
US

V. Phone/Fax

Practice location:
  • Phone: 718-661-9554
  • Fax: 718-661-9556
Mailing address:
  • Phone: 718-661-9554
  • Fax: 718-661-9556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number206610
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number206610
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: