# LY FAMILY MEDICINE HICKSVILLE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336011485
- **Authorized official:** DR. LIYAN YAO MD (OWNER)
- **Authorized official phone:** (631) 882-1689

## Contact information

- **Practice address:** 101 JERUSALEM AVE, HICKSVILLE, NY 11801-4951
- **Practice address phone:** (516) 681-0681
- **Mailing address:** 36 HILLTOP DR, SYOSSET, NY 11791-2003
- **Mailing address phone:** (631) 882-1689

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/18/2025
- **Last updated:** 09/18/2025