MEDICARE: JIAYI YUAN PHARM D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	059220	NY
2	183500000X	Pharmacist	0012111	CT

General Provider Information

NPI Number	:	1336005438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIAYI YUAN PHARM D

Provider Business Mailing Address
First Line	:	125 DELHI RD
Second Line	:
City	:	SCARSDALE
State	:	NY
Zip	:	10583-1916
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 MAMARONECK AVE
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-1440
Country	:	US
Telephone Number	:	914-287-7650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2026
Last Update Date	:	01/02/2026

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