Organization Active NPI

Yongming Mao Physician PC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Brooklyn, NY
National Provider Identifier
1710019815
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
233817 Issued in NY
Legal business name
YONGMING MAO PHYSICIAN PC
Practice address
1675 W 1St St
Suite 2
Brooklyn, NY 11223-1744
Phone
(718) 690-8682
NPI assigned
Mar 12, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Yongming Mao
Title
President
Phone
(718) 690-8682

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 233817 NY Primary

Addresses

Primary practice location

1675 W 1St St
Suite 2
Brooklyn, NY 11223-1744

Mailing address

1675 W 1St St
Suite 2
Brooklyn, NY 11223-1744

Other identifiers 1

IdentifierTypeStateIssuer
02758881MedicaidNY

National Provider Directory

National Provider Directory

Locations

5722 7th Ave
#2
Brooklyn, NY 11220
Phone (718) 690-8682

829 57th St
Ste 5
Brooklyn, NY 11220
Phone (718) 375-3738

3907 Prince St
Ste 3J
Flushing, NY 11354
Phone (718) 690-8682

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710019815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 W 1ST ST",
            "address_2": "SUITE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 W 1ST ST",
            "address_2": "SUITE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231744",
            "telephone_number": "718-690-8682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YONGMING MAO PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAO",
        "authorized_official_first_name": "YONGMING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-690-8682",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NY",
            "license": "233817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02758881",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.