Healthcare Provider Details

I. General information

NPI: 1710211586
Provider Name (Legal Business Name): ALBERT YEE YEE TOE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 09/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION SQ E
NEW YORK NY
10003-3314
US

IV. Provider business mailing address

160 WATER ST
NEW YORK NY
10038-4922
US

V. Phone/Fax

Practice location:
  • Phone: 516-285-6829
  • Fax:
Mailing address:
  • Phone: 516-285-6829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number005288
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: