MEDICARE: DENISE M. YOUNG-AJOSE MD, MPH

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	207Q00000X	Family Medicine Physician	25MA08025500	NJ
2	207Q00000X	Family Medicine Physician	MD-14650	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2673709	OTHER		UNITED HEALTHCARE
2	3K6389	OTHER		HEALTH NET
3	4865P1	OTHER		EMPIRE BC/BS NY
4	P3755509	OTHER		OXFORD
5	0725268	OTHER		CIGNA
6	1454540	OTHER		AETNA
7	0000278218	OTHER	HI	HMSA BILLING NUMBER
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033162854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE M. YOUNG-AJOSE MD, MPH

Provider Business Mailing Address
First Line	:	632 BROADWAY PH
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10012-2614
Country	:	US
Telephone Number	:	347-943-8131
Fax Number	:

Provider Business Practice Location Address
First Line	:	632 BROADWAY PH
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10012-2614
Country	:	US
Telephone Number	:	347-943-8131
Fax Number	:

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	08/15/2023

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