Individual
XIAO QING OUYANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-2961
(718) 920-2058
Mailing address
4130 BEDFORD AVE, BROOKLYN, NY 11229-2452
(718) 714-9686
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
013968-1
NY
Other
Enumeration date
08/20/2010
Last updated
03/10/2021
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