Healthcare Provider Details
I. General information
NPI: 1184374118
Provider Name (Legal Business Name): ZIYANG XU MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/24/2022
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
550 1ST AVE
NEW YORK NY
10016-6402
US
IV. Provider business mailing address
NYU LANGONE MEDICAL CENTER 550 FIRST AVENUE
NEW YORK NY
10016
US
V. Phone/Fax
- Phone: 646-929-7800
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | 324727 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: