Healthcare Provider Details

I. General information

NPI: 1801860804
Provider Name (Legal Business Name): JONATHAN YOUNG KO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JONATHAN KO MD

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 S ORANGE AVE
NEWARK NJ
07103-2757
US

IV. Provider business mailing address

PO BOX 12023
NEWARK NJ
07101-5023
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-5007
  • Fax:
Mailing address:
  • Phone: 212-427-2666
  • Fax: 212-289-6929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA07926700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number231494-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: