Healthcare Provider Details
I. General information
NPI: 1578281069
Provider Name (Legal Business Name): MINHNGUYEN CAO PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/19/2022
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
487 S BROADWAY
YONKERS NY
10705-3269
US
IV. Provider business mailing address
845 N BROADWAY
WHITE PLAINS NY
10603-2403
US
V. Phone/Fax
- Phone: 914-423-4433
- Fax: 914-423-4433
- Phone: 914-761-0600
- Fax: 914-761-5367
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 35SI00792600 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 027593 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: