Provider Demographics
NPI:1447593025
Name:YI, CHUNHUI (MD, PHD)
Entity type:Individual
Prefix:
First Name:CHUNHUI
Middle Name:
Last Name:YI
Suffix:
Gender:
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-922-4121
Mailing Address - Fax:585-922-4128
Practice Address - Street 1:417 STATE ST STE 439
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6635
Practice Address - Country:US
Practice Address - Phone:207-941-8200
Practice Address - Fax:207-990-4846
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA309475207ZD0900X, 207ZP0102X
MEMD28788207ZP0102X, 207ZD0900X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
14996355OtherCAQH