Healthcare Provider Details

I. General information

NPI: 1477295012
Provider Name (Legal Business Name): CIARRA JOIE QUILON YAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 PACIFIC AVE
ATLANTIC CITY NJ
08401-6713
US

IV. Provider business mailing address

51 CHEROKEE DR
GALLOWAY NJ
08205-3738
US

V. Phone/Fax

Practice location:
  • Phone: 609-441-8074
  • Fax:
Mailing address:
  • Phone: 929-247-6821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME172307
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME172307
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: