Provider Demographics
NPI:1700999091
Name:YON, KATHERINE S (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:S
Last Name:YON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 N WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1875
Mailing Address - Country:US
Mailing Address - Phone:609-567-0200
Mailing Address - Fax:609-704-1482
Practice Address - Street 1:932 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-3646
Practice Address - Country:US
Practice Address - Phone:609-383-0880
Practice Address - Fax:609-383-0658
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08099800208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0112640Medicaid
NJI70652Medicare UPIN
NJ108752Medicare PIN