Healthcare Provider Details

I. General information

NPI: 1720194509
Provider Name (Legal Business Name): JI-QING WEI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 12/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13338 41ST RD 2Q
FLUSHING NY
11355
US

IV. Provider business mailing address

PO BOX 521832
FLUSHING NY
11352-1832
US

V. Phone/Fax

Practice location:
  • Phone: 718-353-7626
  • Fax: 718-353-7625
Mailing address:
  • Phone: 718-353-7626
  • Fax: 718-353-7625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number240769
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: