Provider Demographics
NPI:1902048887
Name:YE, JIQING (MD, PHD)
Entity Type:Individual
Prefix:
First Name:JIQING
Middle Name:
Last Name:YE
Suffix:
Gender:M
Credentials:MD, PHD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1425 PORTLAND AVE
Mailing Address - Street 2:LAB OFFICE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3001
Mailing Address - Country:US
Mailing Address - Phone:585-922-9870
Mailing Address - Fax:585-922-9873
Practice Address - Street 1:1425 PORTLAND AVE
Practice Address - Street 2:LAB OFFICE
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3001
Practice Address - Country:US
Practice Address - Phone:585-922-9870
Practice Address - Fax:585-922-9873
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY266160207R00000X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03638075Medicaid