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General NPI Number Information
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NPI Number | 1205724937
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Entity Type | Individual
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Provider Name | QI KANG YAN
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Gender | Male
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 425 ROBINSON ST
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City | BINGHAMTON
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State | NY
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Zip | 13904-1775
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Country | US
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Telephone | 607-724-1391
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Fax |
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Provider Business Mailing Address
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Address Line | 54 COBBLER CRESCENT
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City | NORTH YORK
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State | ON
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Zip | M3N 2Y7
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Country | CA
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 858566
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License Number State | NY
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