Healthcare Provider Details

I. General information

NPI: 1700716339
Provider Name (Legal Business Name): XIA MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15159 25TH AVE
WHITESTONE NY
11357-3749
US

IV. Provider business mailing address

15159 25TH AVE
WHITESTONE NY
11357-3749
US

V. Phone/Fax

Practice location:
  • Phone: 929-424-4471
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: JIANXIANG XIA
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 929-424-4471