Doctor Name: | RONALD ALLEN YOUNG |
NPI Number: | 1780933564 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 145990 |
Business Practice Address: | 520 Franklin Avenue #102 Garden City, NY - 11530 |
Business Phone Number: | 5167472070 |
Business Fax Number: | |
Mailing Address: | 36 Brompton Road, GARDEN CITY |
State: | NY |
Postal Code: | 11530 |
Phone Number: | 5167472070 |
Fax Number: | |
NPI Enumeration Date: | 09/07/2012 |
NPI Last Update Date: | 09/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 145990 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |