Healthcare Provider Details

I. General information

NPI: 1912526120
Provider Name (Legal Business Name): DR. MELANIE GAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date: 04/10/2020
Reactivation Date: 05/12/2020

III. Provider practice location address

5645 MAIN ST
FLUSHING NY
11355-5045
US

IV. Provider business mailing address

2649 STRANG BLVD STE 304
YORKTOWN HEIGHTS NY
10598-2938
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-1033
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number323080
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: