Provider Demographics
NPI:1972816494
Name:YIRENCHI, DOREEN A (FNP-C)
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:A
Last Name:YIRENCHI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HYGEIA DR STE 1420
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:302-623-3017
Mailing Address - Fax:302-266-9962
Practice Address - Street 1:200 HYGEIA DR STE 1420
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2049
Practice Address - Country:US
Practice Address - Phone:302-623-3017
Practice Address - Fax:302-266-9962
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0055914163W00000X
NYF335981-1363LF0000X
DELG-0001417363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03381317Medicaid
NY03381317Medicaid