Healthcare Provider Details

I. General information

NPI: 1730147281
Provider Name (Legal Business Name): TSEHWA YAO DMSC,MPA, MHS, MMS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 03/19/2023
Certification Date: 03/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 MARLBORO RD
MANHASSET NY
11030-3308
US

IV. Provider business mailing address

28 MARLBORO RD
MANHASSET NY
11030-3308
US

V. Phone/Fax

Practice location:
  • Phone: 917-602-3063
  • Fax: 917-970-9539
Mailing address:
  • Phone: 917-602-3063
  • Fax: 917-970-9539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number005711
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: