Active NPI
Xin Fan
- Acupuncturist
- Great Neck, NY
National Provider Identifier
1255720231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 006019
- Practice address
- 54 Radnor Rd
Great Neck, NY 11023-1429 - Phone
- (917) 803-5808
- NPI assigned
- Jan 14, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AK000988 | PA | |
| Acupuncturist | 171100000X | 006019 | NY | Primary |
Addresses
Primary practice location
54 Radnor Rd
Great Neck, NY 11023-1429
Mailing address
54 Radnor Rd
Great Neck, NY 11023-1429
Phone (917) 803-5808
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006019 | NY | MD | Mental Health Counselor |
| AK000988 | PA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698710400000",
"number": "1255720231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 RADNOR RD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110231429",
"telephone_number": "917-803-5808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 RADNOR RD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110231429",
"telephone_number": "917-803-5808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAN",
"first_name": "XIN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-14",
"last_updated": "2023-10-31",
"certification_date": "2023-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "PA",
"license": "AK000988",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "006019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.