MEDICARE: DR. YUANLI XIE M.D.

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	207R00000X	Internal Medicine Physician	279255	NY

General Provider Information

NPI Number	:	1871874453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YUANLI XIE M.D.

Provider Business Mailing Address
First Line	:	8504 21ST AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3208
Country	:	US
Telephone Number	:	347-268-5286
Fax Number	:	718-676-5365

Provider Business Practice Location Address
First Line	:	8504 21ST AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3208
Country	:	US
Telephone Number	:	718-676-9807
Fax Number	:	718-676-5365

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

Provider Enumeration Date	:	09/08/2011
Last Update Date	:	12/18/2025

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