Healthcare Provider Details

I. General information

NPI: 1184798357
Provider Name (Legal Business Name): ALICE C YAO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 NARROWS ROAD SOUTH
STATEN ISLAND NY
10305-2801
US

IV. Provider business mailing address

54 NARROWS ROAD SOUTH
STATEN ISLAND NY
10305-2801
US

V. Phone/Fax

Practice location:
  • Phone: 718-720-6327
  • Fax: 718-270-7461
Mailing address:
  • Phone: 718-720-6327
  • Fax: 718-270-7461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1050291
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number1050291
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number1050291
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: