Provider Demographics
NPI:1104995174
Name:YAN LING GAO, PHYSICIAN, P.C.
Entity type:Organization
Organization Name:YAN LING GAO, PHYSICIAN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YAN LING
Authorized Official - Middle Name:
Authorized Official - Last Name:GAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-271-8686
Mailing Address - Street 1:6 MOUNT AIRY RD
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-2135
Mailing Address - Country:US
Mailing Address - Phone:914-271-8686
Mailing Address - Fax:914-271-8376
Practice Address - Street 1:6 MOUNT AIRY RD
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-2135
Practice Address - Country:US
Practice Address - Phone:914-271-8686
Practice Address - Fax:914-271-8376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2204272084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02186189Medicaid
NYH49889Medicare UPIN
NY383N61Medicare ID - Type Unspecified