Healthcare Provider Details

I. General information

NPI: 1023895224
Provider Name (Legal Business Name): X Y NP IN WOMEN'S HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 51ST AVE APT 3C
LONG IS CITY NY
11101-5957
US

IV. Provider business mailing address

527 51ST AVE APT 3C
LONG IS CITY NY
11101-5957
US

V. Phone/Fax

Practice location:
  • Phone: 646-204-6111
  • Fax:
Mailing address:
  • Phone: 646-204-6111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: XUE YAO LI
Title or Position: NURSE PRACTITIONER
Credential:
Phone: 646-204-6111