Provider Demographics
NPI:1396782892
Name:AHN, YOON J (MD)
Entity type:Individual
Prefix:
First Name:YOON
Middle Name:J
Last Name:AHN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2228 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-3923
Mailing Address - Country:US
Mailing Address - Phone:215-467-8795
Mailing Address - Fax:215-467-8956
Practice Address - Street 1:2228 S BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19145-3923
Practice Address - Country:US
Practice Address - Phone:215-467-8795
Practice Address - Fax:215-467-8956
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD061394L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG50853Medicare UPIN