Provider Demographics
NPI:1952353120
Name:YOH MEDICAL ASSOCIATION
Entity Type:Organization
Organization Name:YOH MEDICAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-429-5861
Mailing Address - Street 1:22 HEARTHSTONE DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2954
Mailing Address - Country:US
Mailing Address - Phone:732-516-9170
Mailing Address - Fax:801-515-9177
Practice Address - Street 1:833 58TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3609
Practice Address - Country:US
Practice Address - Phone:732-429-5861
Practice Address - Fax:801-515-9177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219028207L00000X
NY222038207L00000X
NY227986207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02199379Medicaid
NY02359460Medicaid
NY8L7041Medicaid
NY8K0321Medicare ID - Type Unspecified
NY8L7041Medicaid
NY02386574Medicare ID - Type Unspecified
NY02359460Medicaid
NYH86703Medicare UPIN
NY8L5191Medicare ID - Type Unspecified