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NPI 1821024506

NPI 1821024506 : NICOLE YI M.D. : ROME, NY

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General NPI Number Information
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    NPI Number           |    1821024506
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    Entity Type          |    Individual 
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    Provider Name        |    NICOLE YI M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/24/2006
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    Last Update Date     |    03/04/2025
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Provider Practice Location Address
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    Address Line         |    1500 N JAMES ST 
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    City                 |    ROME
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    State                |    NY
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    Zip                  |    13440-2844
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    Country              |    US
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    Telephone            |    315-338-7000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 2005 
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    City                 |    EAST SYRACUSE
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    State                |    NY
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    Zip                  |    13057-4505
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    Country              |    US
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    Telephone            |    315-449-0513
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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        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    207460
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    License Number State |    NY
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