Provider Demographics
NPI:1558693606
Name:YUAN, RUIRONG (MD)
Entity Type:Individual
Prefix:DR
First Name:RUIRONG
Middle Name:
Last Name:YUAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HORIZON RD
Mailing Address - Street 2:APT. 620
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6743
Mailing Address - Country:US
Mailing Address - Phone:201-224-6627
Mailing Address - Fax:
Practice Address - Street 1:4 HORIZON RD
Practice Address - Street 2:APT. 620
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6743
Practice Address - Country:US
Practice Address - Phone:201-224-6627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-31
Last Update Date:2010-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07683700207RH0003X
NY2185101207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology