Healthcare Provider Details

I. General information

NPI: 1902828916
Provider Name (Legal Business Name): SHELDON C YAO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NORTHERN BLVD ACADEMIC HEALTH CARE CENTER NY INSTITUTE OF TECHNOLOGY
OLD WESTBURY NY
11568-8000
US

IV. Provider business mailing address

NORTHERN BLVD ACADEMIC HEALTH CARE CENTER NY INSTITUTE OF TECHNOLOGY
OLD WESTBURY NY
11568-8000
US

V. Phone/Fax

Practice location:
  • Phone: 516-686-1300
  • Fax: 516-686-7890
Mailing address:
  • Phone: 516-686-1300
  • Fax: 516-686-7890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number229673
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: