MEDICARE: YIFAN CAO

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
1	101YM0800X	Mental Health Counselor		NY

General Provider Information

NPI Number	:	1588548598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YIFAN CAO

Provider Business Mailing Address
First Line	:	9 HOMESTEAD PL APT 2313
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-2888
Country	:	US
Telephone Number	:	612-203-5752
Fax Number	:

Provider Business Practice Location Address
First Line	:	22041 UNION TPKE
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-3542
Country	:	US
Telephone Number	:	347-790-8386
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2025
Last Update Date	:	08/04/2025

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Directions to “ YIFAN CAO ” Practice Location

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