Healthcare Provider Details

I. General information

NPI: 1225692866
Provider Name (Legal Business Name): YUAN JI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2019
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 WHITE PLAINS RD
EASTCHESTER NY
10709-5545
US

IV. Provider business mailing address

685 WHITE PLAINS RD
EASTCHESTER NY
10709-5545
US

V. Phone/Fax

Practice location:
  • Phone: 914-787-4100
  • Fax: 914-787-4199
Mailing address:
  • Phone: 914-787-4100
  • Fax: 914-787-4199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number323487
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: