Provider Demographics
NPI:1780609024
Name:YEE, BONG K (MD)
Entity type:Individual
Prefix:DR
First Name:BONG
Middle Name:K
Last Name:YEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 CHRISLER AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-1826
Mailing Address - Country:US
Mailing Address - Phone:518-370-0010
Mailing Address - Fax:518-370-0050
Practice Address - Street 1:1545 CHRISLER AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-1826
Practice Address - Country:US
Practice Address - Phone:518-370-0010
Practice Address - Fax:518-370-0050
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY132538-1207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00274699Medicaid
NYB82024Medicare UPIN
NY38490BMedicare ID - Type Unspecified