Healthcare Provider Details

I. General information

NPI: 1013797232
Provider Name (Legal Business Name): YANG CAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2023
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15443 25TH DR
FLUSHING NY
11354-1509
US

IV. Provider business mailing address

8006 47TH AVE APT 4E
ELMHURST NY
11373-3568
US

V. Phone/Fax

Practice location:
  • Phone: 646-243-2981
  • Fax:
Mailing address:
  • Phone: 646-243-2981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number032859
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number007734
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: