Healthcare Provider Details

I. General information

NPI: 1730766411
Provider Name (Legal Business Name): XIAOHUA QI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2021
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NICOLLS RD
STONY BROOK NY
11794-8691
US

IV. Provider business mailing address

100 NICOLLS RD
STONY BROOK NY
11790-3407
US

V. Phone/Fax

Practice location:
  • Phone: 631-444-3000
  • Fax: 631-444-3424
Mailing address:
  • Phone: 631-444-3000
  • Fax: 631-444-3424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number340805
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: