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NPI Code Detail

MEDICARE: DR. AUGUSTINE YAO ALIFO M.D.

MEDICARE: DR. AUGUSTINE YAO ALIFO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician35.092137OH
2207P00000XEmergency Medicine Physician25MA06628800NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000579078OTHEROHANTHEM

General Provider Information

NPI Number : 1114926375
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AUGUSTINE YAO ALIFO M.D.
Provider Business Mailing Address
First Line : 312 N HIGHLAND AVE
Second Line :
City : PEARL RIVER
State : NY
Zip : 10965-1005
Country : US
Telephone Number : 973-268-1806
Fax Number :
Provider Business Practice Location Address
First Line : 1 BAY AVE
Second Line :
City : MONTCLAIR
State : NJ
Zip : 07042-4837
Country : US
Telephone Number : 973-429-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 04/19/2022

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