Individual
DR. JASON SHI SAMUEL XIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MSC
Contact information
Practice address
177 FORT WASHINGTON AVE, NEW YORK, NY 10032-3733
(212) 305-3090
Mailing address
177 FORT WASHINGTON AVE, NEW YORK, NY 10032-3733
(212) 305-3090
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2020018991
MO
2084P0800X
Psychiatry Physician
2022037479
MO
2084P0800X
Psychiatry Physician
Primary
327674
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2020
Last updated
05/08/2024
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