Healthcare Provider Details

I. General information

NPI: 1942273875
Provider Name (Legal Business Name): PATRICIA JULIE YOUNG PT, D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 BIRNAM RD
NORTHFIELD MA
01360-9526
US

IV. Provider business mailing address

218 BIRNAM RD
NORTHFIELD MA
01360-9526
US

V. Phone/Fax

Practice location:
  • Phone: 413-387-0722
  • Fax:
Mailing address:
  • Phone: 413-387-0722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number007771
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number007771
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number17287
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: