Individual ProviderXiao HanStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1 Gustave L. Place, Box 1149, New York, NY 10029(212) 824-8069PECOS EnrollmentBased on the most recent information from CMS, provider Xiao Han is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1154717858Provider TypeIndividualFull NameHan, XiaoGenderFemaleSole ProprietorYesEnumeration Date4/9/2015Last Updated2/11/2022Contact InformationPractice LocationPractice Address1 Gustave L. Place, Box 1149, New York, NY 10029Phone(212) 824-8069FaxUnlisted FaxMailing LocationMailing AddressBox 1149, 1 Gustave L. Place,, New York, NY 10029Phone(212) 824-8069FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer