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NPI Code Detail

MEDICARE: FREDDIE YOUNG III

MEDICARE:   FREDDIE  YOUNG III
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1710662622
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDDIE YOUNG III
Provider Business Mailing Address
First Line : 3541 CUMMINGS RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-2650
Country : US
Telephone Number : 216-246-4637
Fax Number :
Provider Business Practice Location Address
First Line : 3541 CUMMINGS RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-2650
Country : US
Telephone Number : 216-246-4637
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2023
Last Update Date : 06/19/2023

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Directions to “ FREDDIE YOUNG III ” Practice Location

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