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NPI Code Detail

MEDICARE: XIAO QIU QU

MEDICARE: XIAO QIU QU
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
1174400000XSpecialist851574NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1174400000XOTHERNYEDUCATION

General Provider Information

NPI Number : 1396187134
Entity Type Code : Individual
Provider Name (Legal Business Name) : XIAO QIU QU
Provider Business Mailing Address
First Line : 28 STUART DR
Second Line :
City : SYOSSET
State : NY
Zip : 11791-5125
Country : US
Telephone Number : 917-887-2211
Fax Number :
Provider Business Practice Location Address
First Line : 500 BI COUNTY BLVD
Second Line : SUITE 114
City : FARMINGDALE
State : NY
Zip : 11735-3988
Country : US
Telephone Number : 516-753-6507
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2013
Last Update Date : 04/13/2026

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Directions to “ XIAO QIU QU ” Practice Location

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