Healthcare Provider Details

I. General information

NPI: 1154356616
Provider Name (Legal Business Name): BRIAN DAVID YIRINEC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/03/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 RED CREEK DR
ROCHESTER NY
14623-4272
US

IV. Provider business mailing address

125 RED CREEK DR
ROCHESTER NY
14623-4272
US

V. Phone/Fax

Practice location:
  • Phone: 585-486-0600
  • Fax: 585-486-0649
Mailing address:
  • Phone: 585-486-0600
  • Fax: 585-486-0649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number181276
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number181276
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: