Healthcare Provider Details

I. General information

NPI: 1841224763
Provider Name (Legal Business Name): NORA LOEY YIP MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 SOUTH MANNING BLVD SUITE 310
ALBANY NY
12208-1742
US

IV. Provider business mailing address

PO BOX 14890
ALBANY NY
12212-4890
US

V. Phone/Fax

Practice location:
  • Phone: 518-438-2776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number238798
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: