Healthcare Provider Details

I. General information

NPI: 1427799832
Provider Name (Legal Business Name): LIYAN YAO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4502 82ND ST
ELMHURST NY
11373-3598
US

IV. Provider business mailing address

4502 82ND ST
ELMHURST NY
11373-3598
US

V. Phone/Fax

Practice location:
  • Phone: 718-779-2248
  • Fax: 718-779-2448
Mailing address:
  • Phone: 718-779-2248
  • Fax: 718-779-2448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number338688
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: