Provider Demographics
NPI:1871874453
Name:XIE, YUANLI (MD)
Entity type:Individual
Prefix:DR
First Name:YUANLI
Middle Name:
Last Name:XIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1664 BAY RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-5135
Mailing Address - Country:US
Mailing Address - Phone:347-268-5286
Mailing Address - Fax:
Practice Address - Street 1:8504 21ST AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3208
Practice Address - Country:US
Practice Address - Phone:347-766-2262
Practice Address - Fax:718-676-5365
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60785-20207R00000X
NY279255207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine