Healthcare Provider Details

I. General information

NPI: 1467694372
Provider Name (Legal Business Name): MELISSA LAI-YING YIP O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14008 SANFORD AVE STE 1
FLUSHING NY
11355-2689
US

IV. Provider business mailing address

14008 SANFORD AVE STE 1
FLUSHING NY
11355-2689
US

V. Phone/Fax

Practice location:
  • Phone: 718-353-3211
  • Fax: 718-353-3212
Mailing address:
  • Phone: 718-353-3211
  • Fax: 718-353-3212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number007382
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: