MEDICARE: SARA XU MD

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	2084P0804X	Child & Adolescent Psychiatry Physician	328872-01	NY
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2084P0800X	Psychiatry Physician	328872-01	NY

General Provider Information

NPI Number	:	1588244131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA XU MD

Provider Business Mailing Address
First Line	:	7559 263RD ST
Second Line	:
City	:	GLEN OAKS
State	:	NY
Zip	:	11004-1150
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7959 263RD ST
Second Line	:
City	:	GLEN OAKS
State	:	NY
Zip	:	11004-1306
Country	:	US
Telephone Number	:	718-470-3500
Fax Number	:

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

Provider Enumeration Date	:	04/08/2021
Last Update Date	:	03/05/2026

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Directions to “ SARA XU MD” Practice Location

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