Provider Demographics
NPI:1265504062
Name:YE, MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:YE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MINGQI
Other - Middle Name:
Other - Last Name:YE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:865 STONE ST
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2742
Mailing Address - Country:US
Mailing Address - Phone:732-499-6139
Mailing Address - Fax:
Practice Address - Street 1:865 STONE ST
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2742
Practice Address - Country:US
Practice Address - Phone:732-499-6139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07317400174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C519840Medicaid
CA00C519840Medicaid
G98730Medicare UPIN