Provider Demographics
NPI:1174572440
Name:CHEN, YA LI (MD)
Entity type:Individual
Prefix:
First Name:YA LI
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:222 ALEXANDER ST
Mailing Address - Street 2:MONROE COURT
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-4039
Mailing Address - Country:US
Mailing Address - Phone:585-922-8350
Mailing Address - Fax:585-922-8355
Practice Address - Street 1:222 ALEXANDER ST
Practice Address - Street 2:MONROE COURT
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-4039
Practice Address - Country:US
Practice Address - Phone:585-922-8350
Practice Address - Fax:585-922-8355
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2022-09-01
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Provider Licenses
StateLicense IDTaxonomies
NY236357207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02836184Medicaid
NY02836184Medicaid
NYI53921Medicare UPIN