Young Jo, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

25MA04060900 Issued in NJ

Practice address

930 Clifton Ave
Suite 102
Clifton, NJ 07013

Phone

(973) 778-2665

Fax

(973) 778-9753

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1255498804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 UNION AVE STE 210",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070701272",
            "telephone_number": "973-778-2665",
            "fax_number": "973-778-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 CLIFTON AVE",
            "address_2": "SUITE 102",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "07013",
            "telephone_number": "973-778-2665",
            "fax_number": "973-778-9753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 Clifton Ave",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Clifton",
            "state": "NJ",
            "postal_code": "070132723",
            "country_code": "US",
            "telephone_number": "973-778-2665",
            "fax_number": "973-778-9753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JO",
        "first_name": "YOUNG",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA04060900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3749509",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ajay V. Jetley, MD
• Jewish Family Service & Childrens Center of Clifton-Passaic, Inc
• Ke Jin, L.AC
• Sierra Jin, M.D.
• Maria K Jinks, D.C.
• Anmar Jobran
• Joel W Rosenberg MD PA
• John Ivan Sutter, MD, PA
• John Scaramia Odpa
• Dana Johnson, APN

• Pulmonary Disease Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Pulmonary Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.