MEDICARE: CHRISTINE XU RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	055069	NY

General Provider Information

NPI Number	:	1255641379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE XU RPH

Provider Business Mailing Address
First Line	:	2018 BAY RIDGE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204
Country	:	US
Telephone Number	:	917-915-2680
Fax Number	:

Provider Business Practice Location Address
First Line	:	4721 8TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-1581
Country	:	US
Telephone Number	:	917-915-2680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2010
Last Update Date	:	10/08/2010

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