Provider Demographics
NPI:1740805035
Name:YI JIA GI MEDICAL P.C.
Entity Type:Organization
Organization Name:YI JIA GI MEDICAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YI
Authorized Official - Middle Name:
Authorized Official - Last Name:JIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-672-6126
Mailing Address - Street 1:70 W 36TH ST # 5C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-8007
Mailing Address - Country:US
Mailing Address - Phone:917-338-7680
Mailing Address - Fax:917-338-6382
Practice Address - Street 1:70 W 36TH ST # 5C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-8007
Practice Address - Country:US
Practice Address - Phone:917-338-7680
Practice Address - Fax:917-338-6382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty