Healthcare Provider Details

I. General information

NPI: 1538207329
Provider Name (Legal Business Name): HUGH HOWARD YOUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 11/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 TILDEN STREET
BRONX NY
10467
US

IV. Provider business mailing address

750 TILDEN STREET
BRONX NY
10467
US

V. Phone/Fax

Practice location:
  • Phone: 718-231-3400
  • Fax: 718-655-3503
Mailing address:
  • Phone: 718-231-3400
  • Fax: 718-655-3503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number137425
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: