Provider Demographics
NPI:1184798357
Name:YAO, ALICE C (MD)
Entity type:Individual
Prefix:DR
First Name:ALICE
Middle Name:C
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 1:54 NARROWS ROAD SOUTH
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2801
Mailing Address - Country:US
Mailing Address - Phone:718-720-6327
Mailing Address - Fax:718-270-7461
Practice Address - Street 1:54 NARROWS ROAD SOUTH
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-2801
Practice Address - Country:US
Practice Address - Phone:718-720-6327
Practice Address - Fax:718-270-7461
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1050291208000000X, 2080N0001X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Not Answered2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00753879Medicaid
NY0042032OtherUS HEALTHCARE
NY105029A18OtherHEALTH FIRST PROVIDER ID
NY00753879Medicaid