Provider Demographics
NPI:1497177323
Name:DORNEICH, YAN
Entity Type:Individual
Prefix:
First Name:YAN
Middle Name:
Last Name:DORNEICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YAN
Other - Middle Name:
Other - Last Name:GU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2 HOT METAL ST
Mailing Address - Street 2:QUANTUM ONE, SUITE 001
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2348
Mailing Address - Country:US
Mailing Address - Phone:412-647-3087
Mailing Address - Fax:412-432-5640
Practice Address - Street 1:120 LYLTON AVE, STE 300
Practice Address - Street 2:UPMC KIDNEY CLINIC
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213
Practice Address - Country:US
Practice Address - Phone:412-802-3043
Practice Address - Fax:412-802-4950
Is Sole Proprietor?:No
Enumeration Date:2014-01-12
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD457090207RN0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program