Healthcare Provider Details

I. General information

NPI: 1003829110
Provider Name (Legal Business Name): DR. YANJIE QI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 07/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE BOX SURG
ROCHESTER NY
14642-8410
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX SURG
ROCHESTER NY
14642-8410
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-3022
  • Fax: 585-276-7851
Mailing address:
  • Phone: 585-275-3022
  • Fax: 585-276-7851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number251347
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number251347
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: