Healthcare Provider Details

I. General information

NPI: 1245758937
Provider Name (Legal Business Name): CALVIN YAU ANP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2017
Last Update Date: 09/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N BROADWAY
SLEEPY HOLLOW NY
10591-1020
US

IV. Provider business mailing address

45 E HARTSDALE AVE APT 4F
HARTSDALE NY
10530-2765
US

V. Phone/Fax

Practice location:
  • Phone: 914-366-3000
  • Fax:
Mailing address:
  • Phone: 914-220-2958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF308284-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: