Provider Demographics
NPI:1588956601
Name:YIP, MICHAEL C M
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C M
Last Name:YIP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE LINDEN OAKS MEDICAL CAMPUS
Mailing Address - Street 2:30 HAGEN DRIVE, SUITE 220
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2658
Mailing Address - Country:US
Mailing Address - Phone:585-295-5476
Mailing Address - Fax:585-248-2112
Practice Address - Street 1:THE LINDEN OAKS MEDICAL CAMPUS
Practice Address - Street 2:30 HAGEN DRIVE, SUITE 22
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2658
Practice Address - Country:US
Practice Address - Phone:585-295-5314
Practice Address - Fax:585-248-0567
Is Sole Proprietor?:No
Enumeration Date:2011-05-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY384353207X00000X
NY284353207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery