Provider Demographics
NPI:1164224648
Name:MICHELLE YAO MD PC
Entity type:Organization
Organization Name:MICHELLE YAO MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:YAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-864-3847
Mailing Address - Street 1:21 BEAUPRE CT
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2329
Mailing Address - Country:US
Mailing Address - Phone:516-864-3847
Mailing Address - Fax:
Practice Address - Street 1:366 N BROADWAY STE LE1
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2000
Practice Address - Country:US
Practice Address - Phone:516-715-3511
Practice Address - Fax:516-715-3511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty