Healthcare Provider Details

I. General information

NPI: 1164392767
Provider Name (Legal Business Name): QIKAI YAO PHYSICIAN, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2025
Last Update Date: 11/08/2025
Certification Date: 11/08/2025
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 Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. QIKAI YAO
Title or Position: MD
Credential: MD
Phone: 718-779-2248