Provider Demographics
NPI:1609945765
Name:YAO, REFENG (MD)
Entity Type:Individual
Prefix:
First Name:REFENG
Middle Name:
Last Name:YAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 LAKE SHORE RD
Mailing Address - Street 2:APARTMENT #3
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-6316
Mailing Address - Country:US
Mailing Address - Phone:617-789-3000
Mailing Address - Fax:
Practice Address - Street 1:CARITAS ST. ELIZABETH 'S HOSPITAL
Practice Address - Street 2:736 CAMBRIDGE STREET
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:01235
Practice Address - Country:US
Practice Address - Phone:617-789-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230483207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2134616Medicaid
MA000094801Medicare PIN