Provider Demographics
NPI:1851488860
Name:YANG, QI RUI (MD)
Entity Type:Individual
Prefix:
First Name:QI RUI
Middle Name:
Last Name:YANG
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 1:919 WESTFALL RD STE A100
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2691
Mailing Address - Country:US
Mailing Address - Phone:585-442-4141
Mailing Address - Fax:585-442-6259
Practice Address - Street 1:919 WESTFALL RD STE A100
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2691
Practice Address - Country:US
Practice Address - Phone:585-442-4141
Practice Address - Fax:585-442-6259
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2626992084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02819423Medicaid
NY00246075Medicaid