Healthcare Provider Details

I. General information

NPI: 1497778724
Provider Name (Legal Business Name): YIRAN DAI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 IRVING AVE C377 (DEPT. OF PATHOLOGY)
SYRACUSE NY
13210-2716
US

IV. Provider business mailing address

6749 SERAH LN
JAMESVILLE NY
13078-9690
US

V. Phone/Fax

Practice location:
  • Phone: 315-425-4399
  • Fax: 315-425-4805
Mailing address:
  • Phone: 315-469-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number235225
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number235225
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: