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Individual

XIAOWEN REN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-5731
Mailing address
4293 RICHMOND AVE, STATEN ISLAND, NY 10312-6241
(917) 498-9993

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
07/03/2023
Last updated
11/27/2023
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