Healthcare Provider Details

I. General information

NPI: 1972526671
Provider Name (Legal Business Name): YURONG CAI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 09/27/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BROOKDALE PLZ
BROOKLYN NY
11212-3198
US

IV. Provider business mailing address

4309 244TH ST
DOUGLASTON NY
11363-1848
US

V. Phone/Fax

Practice location:
  • Phone: 718-283-8816
  • Fax: 718-851-4892
Mailing address:
  • Phone: 718-423-4494
  • Fax: 718-423-4494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number215384
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: