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General NPI Number Information
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NPI Number | 1225398704
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Entity Type | Individual
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Provider Name | YI JIA MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2012
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Last Update Date | 08/26/2022
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Provider Practice Location Address
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Address Line | 70 W 36TH ST # 5C
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City | NEW YORK
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State | NY
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Zip | 10018-8007
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Country | US
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Telephone | 917-338-7680
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Fax | 917-338-6382
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Provider Business Mailing Address
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Address Line | 70 W 36TH ST UNIT 5C
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City | NEW YORK
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State | NY
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Zip | 10018-8007
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Country | US
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Telephone | 917-338-7680
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Fax | 917-338-6382
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD463601
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 0101269644
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 296750
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License Number State | NY
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