MEDICARE: YONG JI M.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	207RH0000X	Hematology (Internal Medicine) Physician	25MA07892700	NJ
2	207RH0003X	Hematology & Oncology Physician	35.152190	OH

General Provider Information

NPI Number	:	1518963875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YONG JI M.D.

Provider Business Mailing Address
First Line	:	54 COVINGTON LN
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-4104
Country	:	US
Telephone Number	:	856-630-7312
Fax Number	:

Provider Business Practice Location Address
First Line	:	1946 TOWN PARK BLVD STE 310
Second Line	:
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-8327
Country	:	US
Telephone Number	:	330-896-5010
Fax Number	:

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	12/18/2024

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