Healthcare Provider Details

I. General information

NPI: 1780609024
Provider Name (Legal Business Name): BONG K YEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 12/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 CHRISLER AVE
SCHENECTADY NY
12303-1826
US

IV. Provider business mailing address

1545 CHRISLER AVE
SCHENECTADY NY
12303-1826
US

V. Phone/Fax

Practice location:
  • Phone: 518-370-0010
  • Fax: 518-370-0050
Mailing address:
  • Phone: 518-370-0010
  • Fax: 518-370-0050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number132538-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: