Healthcare Provider Details

I. General information

NPI: 1588573307
Provider Name (Legal Business Name): ANDREW W KAO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 VAN NEST AVE
BRONX NY
10462-4031
US

IV. Provider business mailing address

940 VAN NEST AVE
BRONX NY
10462-4031
US

V. Phone/Fax

Practice location:
  • Phone: 718-882-4054
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number031344-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: