MEDICARE: WINNIE XU

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1902763071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WINNIE XU

Provider Business Mailing Address
First Line	:	39 LASALLE AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14214-1449
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	39 LASALLE AVE APT 117
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14214-1453
Country	:	US
Telephone Number	:	917-601-1875
Fax Number	:

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

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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Directions to “ WINNIE XU ” Practice Location

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