Healthcare Provider Details

I. General information

NPI: 1982334991
Provider Name (Legal Business Name): NENGLIANG YAO PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2022
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5513 BURBERRY LN
GLEN ALLEN VA
23059-5379
US

IV. Provider business mailing address

5513 BURBERRY LN
GLEN ALLEN VA
23059-5379
US

V. Phone/Fax

Practice location:
  • Phone: 814-380-1251
  • Fax:
Mailing address:
  • Phone: 814-380-1251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: