Provider Demographics
NPI:1073688073
Name:GNO, NICOLAS YAP (MD)
Entity Type:Individual
Prefix:MR
First Name:NICOLAS
Middle Name:YAP
Last Name:GNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458
Mailing Address - Country:US
Mailing Address - Phone:646-477-9636
Mailing Address - Fax:718-733-2037
Practice Address - Street 1:2445 ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458
Practice Address - Country:US
Practice Address - Phone:646-477-9631
Practice Address - Fax:718-733-2037
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115291174400000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00566376Medicaid
NYE56267Medicare UPIN
NY510251Medicare ID - Type Unspecified