Provider Demographics
NPI:1306914957
Name:YU, YI-HAO (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:YI-HAO
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 RIVERSIDE DR
Mailing Address - Street 2:#4D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-3202
Mailing Address - Country:US
Mailing Address - Phone:646-467-4534
Mailing Address - Fax:203-863-4167
Practice Address - Street 1:55 HOLLY HILL LN
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6074
Practice Address - Country:US
Practice Address - Phone:203-863-3750
Practice Address - Fax:203-863-4168
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD435340207RE0101X, 207R00000X, 2083P0901X
NY209532207R00000X, 207RE0101X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD435340OtherPA MEDICAL LICENSE
PAYU2073780OtherPA HIGHMARK BLUE SHIELD
PA145571V8GOtherMEDICARE INDIVIDUAL #
PA50081638OtherCAPITAL BLUE CROSS INDIV#
PA108365OtherMEDICARE GROUP #
PA50081637OtherCAPITAL BLUE CROSS GROUP#