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General NPI Number Information
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NPI Number | 1508738659
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Entity Type | Organization
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Legal Business Name | LY FAMILY MEDICINE ELMHURST
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 4502 82ND ST
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City | ELMHURST
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State | NY
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Zip | 11373-3598
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Country | US
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Telephone | 718-779-2248
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Fax | 718-779-2448
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Provider Business Mailing Address
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Address Line | 36 HILLTOP DR
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City | SYOSSET
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State | NY
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Zip | 11791-2003
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Country | US
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Telephone | 631-882-1689
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LIYAN YAO
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Credential | MD
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Telephone | 631-882-1689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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