Healthcare Provider Details

I. General information

NPI: 1588956601
Provider Name (Legal Business Name): MICHAEL C M YIP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2011
Last Update Date: 09/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THE LINDEN OAKS MEDICAL CAMPUS 30 HAGEN DRIVE, SUITE 22
ROCHESTER NY
14625-2658
US

IV. Provider business mailing address

THE LINDEN OAKS MEDICAL CAMPUS 30 HAGEN DRIVE, SUITE 220
ROCHESTER NY
14625-2658
US

V. Phone/Fax

Practice location:
  • Phone: 585-295-5314
  • Fax: 585-248-0567
Mailing address:
  • Phone: 585-295-5476
  • Fax: 585-248-2112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number384353
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number284353
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: